G6017 prior authorization | Blue Cross and Blue Shield of Montana

G6017, Intra-Fraction Localization And Tracking Of Target Or Patient Motion During Delivery Of Radiation Therapy (Eg 3D Positional Tracking Gating 3D Surface Tracking) Each Fraction Of Treatment, is on the Blue Cross and Blue Shield of Montana commercial prior authorization list. Not a coverage or referral decision.

Code: G6017
Description: Intra-Fraction Localization And Tracking Of Target Or Patient Motion During Delivery Of Radiation Therapy (Eg 3D Positional Tracking Gating 3D Surface Tracking) Each Fraction Of Treatment
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 269 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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