Palmetto/CMS/LCD not covering R sided IMRT APBI
Has anyone else seen this?
I'm seeing that in spite of NCCN saying 30/5 IMRT is the preferred APBI approach, Palmetto (the LCD for a huge chunk of the country) is not covering IMRT even for APBI in R sided breast cases.
Is this correct?
Is this something that is amenable to any appeals?
Absolutely insane that a relatively cheap treatment, proven in a phase 3 trial, listed in NCCN guidelines as the preferred technique/fractionation....is not paid for by cms.
Source: Student Doctor Network - Category: Universities & Medical Training Authors: BobbyHeenan Tags: Radiation Oncology Source Type: forums