Our Clean Sweep Live Auction is coming up fast! Next Tuesday, September 26th at 9:30AM EST

DOTmed Home MRI Oncology Ultrasound Molecular Imaging X-Ray Cardiology Health IT Business Affairs
News Home Parts & Service Operating Room CT Women's Health Proton Therapy Endoscopy HTMs Mobile Imaging
Current Location:
> This Story

Log in or Register to rate this News Story
Forward Printable StoryPrint Comment


Oncology Homepage

ASTRO Product Showcase Some of the products and services on display at ASTRO 2017

The future of radiation therapy: Integrated MR guidance Insights from Joel Goldwein, senior vice president of medical affairs at Elekta

Alan Baron Proton Partners International appoints New Board Member

Penn Medicine treats first patient with Varian Halcyon radiation treatment platform Cuts down on time and costs

International Atomic Energy Agency in partnership to get new Varian linac Will help the agency answer requests for standards and guidance

Study finds MR detects 98 percent of pregnancy-related breast cancers May also inform surgical management of disease

Mevion submits MEVION S250i for premarket approval Features improved pencil-beam scanning

Radiology Partners to acquire Southwest Diagnostic Imaging Joining with SDI 'represents about a 25 percent increase' in RP's size

Q&A with Brian Kavanagh ASTRO president Find out what to expect at this year's meeting and what plans are in place for the coming year

Laparoscopic surgery for pancreatic cancer offers shorter hospital stays than open surgery But the procedure takes longer

Proton therapy room
Courtesy of Penn Medicine

ASTRO releases updated insurance coverage recommendations for proton therapy

by Lauren Dubinsky , Senior Reporter
In light of new research, the American Society for Radiation Oncology recently made updates to its insurance coverage guidelines for proton beam therapy.

"This policy update reflects the most current knowledge regarding which patients will benefit from — and therefore should have access to — this cutting-edge treatment," Dr. David C. Beyer, ASTRO Chair, said in a statement.

Story Continues Below Advertisement

Introducing HALCYON

We set out to rethink the way we approached radiotherapy, so you can redefine the way you fight cancer. Visit us at ASTRO booth #717. Click above to learn more

The original policy was issued in 2014 when the technology was still in its infancy. The updated Proton Beam Therapy Model Policy provides guidance on the clinical indications that are appropriate for treatment and should be covered by Medicare, Medicaid and private insurance.

The clinical indications are divided into two categories, based on evidence from published clinical data and current Medicare coverage. Coverage is recommended for Group 1, but it's only recommended for Group 2 if additional requirements are met.

For Group 1, five additions and one modification were made to the original guidelines:

  • Malignant and benign primary central nervous system tumors

  • Advanced and/or unresectable head and neck cancers

  • Cancers of the paranasal sinuses and other accessory sinuses

  • Nonmetastatic retroperitoneal sarcomas

  • Reirradiation cases where cumulative critical structure dose would exceed tolerance dose

  • Hepatocellular cancer is no longer required to be treated in a hypofractionated regimen

For Group 2, coverage is recommended if the patient is enrolled in an Institutional Research Board-approved study or a multi-institutional registry that adheres to Medicare's Coverage with Evidence Development (CED) requirements.

However, evidence is accumulating for these indications that may push them into Group 1 in the future. Even though the policy states that no indications are considered inappropriate for CED, it does specify several systems for Group 2 indications:

  • Non-T4 and resectable head and neck cancers (previously it was all head and neck malignancies)

  • Nonmetastatic prostate cancer (previously it was grouped with genitourinary carcinomas)

Beyer said that ASTRO is committed to developing evidence to identify new areas where proton therapy may be beneficial as well as situations where it might not be.

ASTRO's Payer Relations Subcommittee developed the update guidelines, which were reviewed by the Health Policy Council and approved by the Board of Directors last month.

Back to HCB News
  Pages: 1

Oncology Homepage

You Must Be Logged In To Post A Comment

Increase Your
Brand Awareness
Auctions + Private Sales
Get The
Best Price
Buy Equipment/Parts
Find The
Lowest Price
Daily News
Read The
Latest News
Browse All
DOTmed Users
Ethics on DOTmed
View Our
Ethics Program
Gold Parts Vendor Program
Receive PH
Gold Service Dealer Program
Receive RFP/PS
Healthcare Providers
See all
HCP Tools
A Job
Parts Hunter +EasyPay
Get Parts
Recently Certified
View Recently
Certified Users
Recently Rated
View Recently
Certified Users
Rental Central
Rent Equipment
For Less
Sell Equipment/Parts
Get The
Most Money
Service Technicians Forum
Find Help
And Advice
Simple RFP
Get Equipment
Virtual Trade Show
Find Service
For Equipment
Access and use of this site is subject to the terms and conditions of our LEGAL NOTICE & PRIVACY NOTICE
Property of and Proprietary to DOTmed.com, Inc. Copyright ©2001-2017 DOTmed.com, Inc.