Superficial Radiation Therapy (SRT) for the Treatment of Nonmelanoma Skin Cancers (NMSC)

Superficial radiation therapy (SRT) is covered for low-risk and high-risk cutaneous BCC and SCC, and for SCC in situ, only when the medical record documents the patient is a nonsurgical candidate and risk stratification follows NCCN/AAD/ASTRO guidelines. Electronic brachytherapy (EBT) and HRUS-guided SRT are not covered; SRT is excluded for surgical candidates, very high-risk SCC, tumors >4 cm, lesions >6 mm depth, aggressive histology, perineural/perivascular invasion as sole therapy, prior-irradiated fields, and other contraindications to RT. Providers and facilities must meet specified training and radiation safety/regulatory requirements and document medical necessity and guideline-based risk assignment.

"SRT is reasonable and necessary for treatment of low-risk basal cell carcinoma (BCC) when medical record documents the patient is a nonsurgical candidate."