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

SRT is covered as the primary treatment for cutaneous low-risk or high-risk BCC and SCC, and for SCC in situ, only when the patient is documented as a nonsurgical candidate and medical necessity is supported in the record. SRT is not covered for first-line treatment in surgical candidates, for advanced or very-high-risk SCC, lesions >4 cm or >6 mm depth, aggressive morphology, tumors in previously irradiated fields, tumors with perineural/perivascular invasion as sole therapy, nor for HRUS-guided SRT or electronic brachytherapy (EBT). Providers must be appropriately trained and facilities must meet radiation safety and supervision requirements.

"SRT is covered when used as the primary treatment modality for a cutaneous low-risk or high-risk basal cell carcinoma (BCC) per NCCN/ASTRO/AAD guidelines, with documented medical necessity and docu..."

Sign up to see full coverage criteria, indications, and limitations.