Does 55860 require prior authorization?

No, 55860 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 55860?

Medicare facility rate: $785.92. Non-facility rate: $785.92. Work RVU: 15.44.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

15.44

Facility

$785.92

Non-Facility

$785.92

0: Fully active; no performance restrictions.
Ta: Noninvasive localized squamous cell carcinoma
No documentation requirements are specified in this document excerpt. Refer to the referenced corresponding medical/pharmacy coverage policies for required medical records, test results, and clinical documentation.
No specific documentation requirements are provided in the provided excerpt.

Treatment of unresectable primary hepatocellular carcinoma (HCC) with Theraspheres (glass yttrium-90 microspheres).
Electronic brachytherapy for skin lesions
Conformal external beam radiation
Particle beam radiation for various tumor indications
Three-dimensional reference system for radiation treatment
Brachytherapy is a form of treatment, used for both oncologic and non-oncologic conditions, in which radioactive materials are placed inside the body.

CARELON-radiation-therapy-excludes-proton-2025-03-23 — Radiation Therapy Excludes Proton

HUMANA-BRACHYTHERAPY-MA — Brachytherapy - Medicare Advantage

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