WPS Legacy Part A Medicare Contractor SBRT Policy Update

Dear CKC Members,

The CyberKnife Coalition (CKC) would like to inform you that Wisconsin Physician Services (WPS), the nationwide Legacy Part A Medicare contractor (formerly Mutual of Omaha Part A), has issued favorable coverage guidance for prostate SBRT. This contractor recently retired its SBRT policy (LCD L261 09) and replaced it with LCD L28366. By updating its outdated Legacy Part A policy, WPS now has a consistent and favorable coverage policy in all states where it administers Medicare benefits.

The new SBRT LCD and a list of added diagnoses can be found on WPS’ website at the following html address: http://www.wpsmedicare.com/part a/policylactive/local/128366 rad039. shtml

This updated policy formalizes WPS’ positive position on prostate cancer previously stated in a Dec 2008 Communique that, at the time, only applied to its Legacy Part B states (WI, IL, Ml, and MN) and JS MAC jurisdiction (lA, NE, KS, and MO). With this latest update, WPS has met its goal of establishing consistent and clear coverage for its providers nationwide. This decision by WPS is consistent with the growing payer acceptance and the trend toward coverage of CyberKnife.

This policy change did not happen overnight and it did not happen without the efforts of our members who worked together to achieve this result. The CKC will continue to work toward breaking down barriers that deny access to patients who would benefit from CyberKnife treatment. By doing so we hope patients treated with CyberKnife will be able to lead more fulfilling and healthy lives. In the words of John Quincy Adams, “Patience and perseverance have a magical effect before which difficulties disappear and obstacles vanish”. We hope you will persevere with us.