Hyperthermia for Treatment of Cancer - Medicare Advantage

Humana's Medicare Advantage policy recognizes certain hyperthermia procedures as medically reasonable and necessary under defined criteria: HIPEC in adults (≥18) when performed with cytoreductive surgery for specified peritoneal malignancies; ILI/ILP for stage III in-transit melanoma; and HIFU as salvage therapy for recurrent prostate cancer after radiation with no metastases. The policy excludes deep hyperthermia (>4 cm), whole-body hyperthermia, and several emerging/local hyperthermia technologies (eg, histotripsy, magnetic nanoparticle hyperthermia, LITT, water vapor thermotherapy) as not medically reasonable and necessary.

"HIPEC is limited to patients 18 years of age or older and must be used in conjunction with cytoreductive surgery (CRS)."

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