Expert Guidance for Hospitals & Free-Standing Clinics On New Reimbursement Rules
Under the 2026 Final Rules, active motion management has been formally incorporated into higher-complexity radiation treatment delivery codes. This change acknowledges the role of SGRT in treatment delivery and supports its appropriate use for delivering precise, active motion management to more patients while streamlining operations.
The table below summarizes the new treatment delivery codes and national average reimbursement rates for hospital and free-standing settings:
| 77402 Simple | 77407 Intermediate | 77412 Complex |
| Radiation treatment delivery; Level 1 (for example, single electron field, multiple electron fields, or 2D photons), including imaging guidance, when performed | Radiation treatment delivery; Level 2, single isocenter (eg, 3D or IMRT), photons, including imaging guidance, when performed | Radiation treatment delivery; Level 3, multiple isocenters with photon therapy (for example, 2D, 3D, or IMRT) OR a single isocenter photon therapy (eg, 3D or IMRT) with active motion management, OR total skin electrons, OR mixed electron/photon field(s), including imaging guidance, when performed |
| Free-standing: $79.49 Hospitals: $104.24 |
Free-standing: $317.64 Hospitals: $394.05 |
Free-standing: $391.46 Hospitals: $564.51 |
| CPT 77387-26 |
| Professional Charge Code – Image Guidance (including SGRT) |
| $36.74 MPFS |
| Guidance for localization of target volume for delivery of radiation treatment, includes intrafraction tracking, when performed |
On-demand webinars focused on newly changed reimbursement rules in the US:
Best Billing Practices - 2/12/26
Sally Eggleston and Leah Harlin, radiation oncology consulting and billing experts from Radiation Business Solutions, outline key considerations for navigating the evolving SGRT billing and reimbursement landscape.
Vision RT’s Michael Niggli also provides insight into SGRT applications and clinical workflows that streamline treatment documentation.
Download the presentation slides: AlignRT Treatment Reports (PDF)
Download the presentation slides: Best Practices for Documentation (PDF)
For Hospitals / HOPPS - 12/4/25
Sally Eggleston and Leah Harlin, radiation oncology consulting and billing experts from Radiation Business Solutions, give an overview of the Final Rule and how it impacts the billing of SGRT for hospitals / HOPPS.
Vision RT’s Ben Waghorn also gives a very brief presentation on SGRT solutions designed to boost clinical efficiency and help automate SGRT financial reporting.
For Free-Standing Clinics - 11/21/25
Sally Eggleston, a radiation oncology consulting and billing expert from Radiation Business Solutions, gives an overview of the Final Rule and how it impacts the billing of SGRT for free-standing clinics.
Vision RT’s Ben Waghorn also provided a brief presentation on SGRT solutions designed to boost clinical efficiency and help automate SGRT financial reporting.
Additional Resources for Navigating the New Reimbursement Rules
Below are some tools from Radiation Business Solutions to help your clinical and billing teams prepare for the 2026 reimbursement updates.
Why Choose AlignRT for SGRT Implementation?
AlignRT enables non-ionizing, continuous intrafraction motion monitoring throughout treatment delivery.
Established Clinical Standard
- Over 20 years of SGRT clinical use
- 3,000+ systems in routine operation worldwide
- Adopted by 24 of the top 25 U.S. News & World Report “Best Hospitals for Cancer”1
Supports Efficient, Routine Clinical Use
Designed for Standardization Across Treatment Environments
- Interoperable with all major linac vendors, independent of system age
- Enables consistent SGRT use and workflows across multi-vendor environments
Built to Support Reliable Use
- Performs reliably across all skin tones
- 99% system uptime target²
- SGRT-focused US service and support team of +60 staff
1 US News & World Reports, 2025-2026
2 If remote connection is approved by customer
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