Photodynamic Therapy for Choroidal Neovascularization

This policy covers verteporfin (Visudyne) photodynamic therapy as monotherapy to occlude choroidal neovascularization (CNV). It is indicated for CNV from neovascular (wet) AMD, pathologic myopia, presumed ocular histoplasmosis, chronic central serous chorioretinopathy, choroidal hemangioma and other vision‑threatening CNV; treatment requires fluorescein angiographic leakage, clinical reevaluation about every 3 months for retreatment, combination use with anti‑VEGF agents is considered experimental and not covered, and coverage is subject to member benefit plan rules and state‑specific provisions (HCSC Ohio).

"Therapies that are proven effective for the relevant diagnosis based on generally accepted standards of practice."

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