Proton Beam, Neutron Beam, and Carbon Ion Radiotherapy

Aetna covers proton-beam radiotherapy for specified indications—primary CNS tumors, certain advanced/unresectable head-and-neck tumors (T4, excluding T1–T2N0M0 laryngeal), paranasal/nasopharyngeal tumors, skull‑base tumors (e.g., chordoma/chondrosarcoma), and malignancies in patients ≤21 years—and deems PBRT experimental/investigational for other adult indications (with PBRT and IMRT considered clinically equivalent for localized intact prostate under plan terms). Neutron-beam therapy is considered experimental/investigational for other indications, carbon‑ion therapy is experimental/investigational for all indications, and coverage requires meeting Aetna’s specific selection criteria and the member’s benefit plan provisions.

"ICD-10 codes covered if selection criteria are met for adults : C01 - C02."

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