Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery – Commercial and Individual Exchange Medical Policyopen_in_new

UnitedHealthcare covers SRS and SBRT as medically necessary for a defined set of intracranial and extracranial benign and malignant indications (e.g., brain metastases, AVMs and benign skull‑base tumors, Stage I NSCLC, selected primary HCC/prostate/renal tumors, unresectable colorectal liver mets, and selected oligometastatic disease), with SRS usually single‑fraction and SBRT typically 2–5 fractions (palliative spine SBRT ≤2). Coverage is contingent on strict criteria—performance status KPS ≥70/ECOG 0–2, lesion count/size and staging limits (e.g., brain mets ≤10 lesions/cumulative volume limits; extracranial oligometastases generally ≤3 lesions ≤5 cm or NSCLC guidance up to 5 mets), absence of leptomeningeal disease, exclusions for lymphoma/germ cell/small cell histologies in brain mets, multidisciplinary review, and required documentation and plan‑specific benefit approval.

"Acoustic neuroma (vestibular schwannoma) Brain metastasis when one of the following criteria is met: Newly diagnosed brain metastasis and all the following criteria are met: Individual has a good p..."