Under the 2026 Final Rules, active motion management is now included in higher-complexity radiation treatment delivery codes. These changes present an opportunity for clinics to expand their usage of Surface Guided Radiation Therapy (SGRT), to benefit their patients.

 

BACKGROUND
Treatment Codes & Reimbursement Rates

The cards below summarize the updated treatment delivery codes and national average reimbursement rates for hospital and free-standing settings.

77402 – Simple
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Radiation treatment delivery; Level 1 (for example, single electron field, multiple electron fields, or 2D photons), including imaging guidance, when performed.

Free-standing
$79.49
Hospitals
$104.24
77407 – Intermediate
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Radiation treatment delivery; Level 2, single isocenter (eg, 3D or IMRT), photons, including imaging guidance, when performed.

Free-standing
$317.64
Hospitals
$394.05
77412 – Complex
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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
$391.46
Hospitals
$564.51
CPT 77387-26
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Professional Charge Code – Image Guidance (including SGRT)

Guidance for localization of target volume for delivery of radiation treatment, includes intrafraction tracking, when performed.

MPFS
$36.74

American Medical Association (AMA) definitions:

Active Motion Management
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Treatment delivery with active motion management (77412) includes intra-fraction localization and tracking of the target(s) or patient motion to optimize beam delivery (eg, intra-fraction motion, surface guidance). Intra-fraction motion management utilizes fiducials or imaging to monitor the target or organs at risk during the breathing cycle (eg, during a deep inspiration breath hold). This method minimizes organ motion and allows more accurate delivery of radiation to mobile targets and active avoidance of OAR.

Surface Guidance
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Surface guidance for active motion management is a technique that allows the linear accelerator to perform gating (eg, optical) during treatment delivery using the body surface contour as a surrogate for internal target motion and OAR avoidance. Surface guidance is one method to effect active motion management, although there are other methods as well.

Note: This is not for patient set-up prior to treatment delivery (eg, not to replace tattoos).

Previous Webinars (Available On-Demand)

Previous educational sessions focused on newly updated U.S. reimbursement rules.

About this webinar
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April 23, 2026

Sally Eggleston and Leah Harlin, radiation oncology consulting and billing experts from Radiation Business Solutions, as well as the ASTRO Health Policy Team share the latest payor news and trends observed in the market and outline best billing practices for active motion management.

Vision RT’s Michael Niggli also provides resources for capturing treatment documentation in AlignRT.

 

About this webinar
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March 12, 2026

Sally Eggleston and Leah Harlin, radiation oncology consulting and billing experts from Radiation Business Solutions, share the latest payor trends and outline best billing practices for active motion management under the new 2026 Final Rules.

Vision RT’s Michael Niggli also provides insight into SGRT applications and AlignRT workflows that support accurate treatment documentation.

About this webinar
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February 12, 2026

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.

Additional Resources for Navigating the New Reimbursement Rules
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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
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  • 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
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Designed for Standardization Across Treatment Environments
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  • 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
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  • 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

Introducing:

Vision RT now offers a tiered SGRT portfolio, enabling clinics to choose the AlignRT configuration that best fits their needs, from AlignRT Core for streamlined adoption, through to the flagship AlignRT product supporting advanced workflows and expanded capabilities.

AlignRT Core serves as an accessible entry point for clinics adopting SGRT, delivering the same high-quality, patient-friendly technology trusted by thousands of clinics worldwide, including 24 of the 25 Best US Hospitals for Cancer.*

*According to US News & World Report rankings

Get in touch

Ready to take the next step?

Vision RT’s family of SGRT solutions guide radiation therapy for better patient care at every step: Sim, Planning, Treatment and Dose. Whether you’re looking for a quote, a product demo (virtual or in-person) or just more information, please get in touch.