Radiation Therapy Authorization Program

Last Updated: Thursday, November 17, 2022

In an effort to help ensure that the radiation oncology therapy services provided to our members are consistent with nationally recognized clinical guidelines, Highmark has contracted with eviCore healthcare to provide medical necessity review and authorization where applicable for select radiation oncology therapy services.

Reference Materials

Read the updated FAQs about the Radiation Therapy Authorization Program.

FAQ’s

This guide includes a summary of all components of the Radiation Therapy Authorization Program and includes the list of procedure codes that require authorization.

Administrative Guide

RT Clinical Guidelines

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The following entities serve central and southeastern Pennsylvania and are independent licensees of the Blue Cross Blue Shield Association: Highmark Inc. d/b/a Highmark Blue Shield, Highmark Benefits Group Inc., Highmark Health Insurance Company, Highmark Choice Company or Highmark Senior Health Company.

All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration and/or to one or more of its affiliated Blue companies