Medicare Increases Coverage for IORT

September 20, 2018

New LCD published for intraoperative radiation therapy

Coverage Update: New Local Coverage Determination (LCD) policy adds IORT coverage to more than 700 hospitals and close to 6 million Medicare beneficiaries in the southeastern U.S. Medicare Administrative Contractor (MAC) Palmetto GBA published a new LCD for intraoperative radiation therapy. According to its website, Plametto GBA administers Medicare Part A and Part B fee-for-Service claims in the states of Alabama, Georgia, Tennessee, Virginia, West Virginian, and North and South Carolina representing approximately 5.8 million Medicare beneficiaries. According to the new policy, which has an effective date of Sept 24, 2018, IORT treatment of several indications is considered reasonable and necessary including: Breast Cancer, Colon and Rectal Cancers, Soft Tissue Sarcomas,  and Uterine and Cervical Cancer.

Newly Covered Indications:


More details for the specifics on the coverage can be viewed at the MCD website.