LCDActive
ProMark® Risk Score
L37011
Wisconsin Physicians Service Insurance Corporation (J05)
Effective: December 28, 2023
Updated: December 31, 2025
Policy Summary
This policy provides limited coverage for the ProMark test to help determine suitability for conservative (active surveillance) management for patients with early-stage, needle biopsy–proven prostate cancer. Coverage is intended to guide selection of patients who may avoid definitive surgery or radiation.
Coverage Criteria Preview
Key requirements from the full policy
"ProMark is covered to assist in determining which patients with early-stage, needle biopsy–proven prostate cancer are suitable for conservative (active surveillance) management instead of definitiv..."
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