Cryosurgical Ablation of the Prostate

This policy covers cryosurgical ablation of the prostate—primarily whole‑gland cryoablation—as a primary treatment for clinically localized (organ‑confined) prostate cancer and as salvage therapy for nonmetastatic recurrence after radiation, while focal/subtotal approaches are currently under evaluation. Coverage is subject to the member’s benefit plan and appropriate patient selection (e.g., nonmetastatic disease and specific PSA/Gleason/stage criteria); subtotal/partial cryoablation is considered experimental/unproven and cryoablation is not indicated for metastatic prostate cancer, with long‑term efficacy and comparative effectiveness still under study.

"Whole-gland cryosurgical ablation as initial treatment for clinically localized (organ-confined) prostate cancer."

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