G6012 prior authorization | Blue Cross and Blue Shield of Montana

G6012, Radiation Treatment Delivery 3 Or More Separate Treatment Areas Custom Blocking Tangential Ports Wedges Rotational Beam Compensators Electron Beam; 6-10Mev, is on the Blue Cross and Blue Shield of Montana commercial prior authorization list. Not a coverage or referral decision.

Code: G6012
Description: Radiation Treatment Delivery 3 Or More Separate Treatment Areas Custom Blocking Tangential Ports Wedges Rotational Beam Compensators Electron Beam; 6-10Mev
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 268 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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