Proton Beam, Neutron Beam and Carbon Ion Radiation Therapy - Medicare Advantage

Covers proton beam, neutron beam, and carbon ion radiation therapy delivery (including CPT 77520/77522/77523/77525 and related G-codes/77423) for oncology indications aligned with Medicare and applicable MAC Local Coverage Determinations and professional guidelines (ACR, ASCO, ASTRO, AUA), including select cancers such as localized prostate cancer, glioblastoma, and salivary gland malignancies. Coverage is limited to services deemed reasonable and necessary per the applicable MAC LCD/NCD (medical necessity per LCD L33937), carbon ion therapy is investigational/not available in the U.S., and neutron therapy is restricted to specialized centers due to higher normal-tissue toxicity.

"Routine Costs in Clinical Trials (NCD 310."

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