Brachytherapy - Medicare Advantage

This policy covers brachytherapy services — including interstitial/intracavitary techniques and radioembolization (TheraSpheres, SIR‑Spheres/SIRT/TARE) — for specified oncologic indications. Coverage is limited to defined populations such as solitary unresectable hepatocellular carcinoma (HCC) 1–8 cm with Child‑Turcotte‑Pugh A, ECOG 0–2, no macrovascular invasion and well‑compensated liver function; SIR‑Spheres for unresectable CRC liver metastases only when used with adjuvant intrahepatic artery chemotherapy; and selected unresectable neuroendocrine liver metastases (symptomatic on or after SSA/systemic therapy), with exclusions for portal vein thrombosis, disseminated extra‑hepatic disease, clinical/decompensated liver failure, adverse vascular anatomy and other scenarios outside the specified criteria.

"Coverage for 'Three-dimensional reference system for radiation treatment' is associated with the 'Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy' medical/pharmacy coverage policy..."