Prior Authorization Update: Radiology
Effective 5/22/2026, Meridian will require prior authorization for the following codes:
- 77520 PROTON BEAM DELIVERY SING TRMT AREA
- 77522 PROTON TX DELIV; SIMPL W/COMPENSATN 0
- 77523 PROTOM BEAM DELIVERY ONE OR TWO TRMT AREAS
- 77525 PROTON TX DELIV; COMPLX 0
- 77371 RAD TX DELIVERY, (SRS), COMPLETE COURSE OF TX OF CEREBRAL LES 1 SESSION
- 77372 LINEAR ACCELERATOR BASED
- 77373 STEREOTACTIC BODY RAD THER, TX DELIV, PER FRACTION TO 1 OR MORE LESIONS
- 77423 NEUTRON BEAM TX COMPLEX
All policies and procedures are regularly reviewed as part of our commitment to deliver quality, cost-effective care for Meridian members. To check if an authorization is needed, please utilize our Medicaid Pre-Auth Check Tool.