Superficial Radiation Therapy (SRT) for the Treatment of Nonmelanoma Skin Cancers (NMSC)
L40178
SRT is covered for low-risk or high-risk cutaneous BCC, low-risk or high-risk cutaneous SCC, and SCC in situ only when the patient is a documented nonsurgical candidate and the medical record supports SRT as the primary modality per NCCN/AAD/ASTRO risk stratification. SRT and EBT have multiple exclusions: HRUS guidance and EBT are not covered; SRT is not covered for surgical candidates, advanced disease, previously irradiated sites, tumors >4 cm, depth >6 mm, aggressive morphologies, perineural/perivascular invasion as sole therapy, or very high‑risk SCC. Documentation must include guideline-based risk stratification, reasons for nonsurgical candidacy or refusal after shared decision-making, pre-treatment depth assessment, and provider/facility credentialing and regulatory compliance.
"Superficial radiation therapy (SRT) is reasonable and necessary for treatment of low-risk or high-risk cutaneous basal cell carcinoma (BCC) when the patient is a nonsurgical candidate and the medic..."