Payer PolicyActive
Grenz Ray Therapy for Skin Disorders
AETNA-CPB-0231
Aetna
Effective: March 29, 2023
Updated: December 6, 2025
created · Dec 2, 2025
Policy Summary
Aetna considers Grenz ray therapy experimental/investigational and does not cover it for treatment of dermatologic conditions due to inadequate evidence and safety concerns (radiation-induced skin cancers); CPT codes 77401 and 96900 are not covered for these indications (billing should use unlisted 77499 if submitted). Use is limited to research settings only (controlled trials, closely observed case series or registry contributions) and it is contraindicated for benign cutaneous lesions, especially of the head and neck.
Coverage Criteria Preview
Key requirements from the full policy
"ICD-10 codes (not covered for indications listed in the CPB) — not all-inclusive: H00."
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