CKC Noridian Announcement

Noridian Administrative Services

Now Covers Prostate Cancer

The CyberKnife Coalition (CKC) is pleased to report that Noridian Administrative Services, the Medicare Part A and B contractor in Alaska, Arizona, Idaho, Minnesota, Montana, North Dakota, Oregon, South Dakota, Utah, Washington and Wyoming, has released its final SRS/SBRT policy, which will soon allow for treatment with CyberKnife for prostate cancer.

What is notable about this policy change is that Noridian was the very first Medicare contractor to adopt a non-coverage policy for prostate cancer nearly 7 years ago. In December that will change, and Medicare beneficiaries in this region will once again have access to CyberKnife treatment.

Covered Indications

  • Primary and metastatic lesions of the brain, spine, lung, liver, kidney, adrenal gland, and pancreas.
  •  Pelvic and head and neck tumors after primary irradiation.
  •  Prostate cancer for patients enrolled in IRB approved clinical trials and registries compliant with AHRQ principles; specifically mentioned is the Registry for Prostate Cancer Radiosurgery (RPCR).
  • Patients with more than 3 primary or metastatic brain lesions who are enrolled in a clinical trial or registry compliant with the principles established in AHRQ’s “Registries for Evaluating Patient Outcomes: A User’s Guide”.

For a complete list of covered diagnoses and coverage criteria, please refer to the final policy, effective 12/3/12, located on the CMS Website at: http://www.cms.gov/medicare-coverage-database/details/lcd- details.aspx?LCDId=32234&ContrId=246.

This positive outcome in the West reflects the hard work and dedication of our members. Our work, unfortunately, doesn’t end there. We now must turn our attention to the South and begin working to address the recently released draft Cahaba SRS/SBRT policy in Alabama, Georgia, and Tennessee, that proposes to limit coverage of indications appropriate for CyberKnife treatment, including prostate cancer.

We look forward to working with stakeholders in this region to ensure the final policy allows appropriate coverage for CyberKnife.