The American Society for Radiation Oncology (ASTRO) has revised its recommendations for medical insurance coverage of the use of proton beam therapy to treat cancer.
The organization's updated Proton Beam Therapy Model Policy offers guidance to payors on which clinical indications are appropriate for treatment with proton therapy and should be covered by health insurance, including Medicare, Medicaid, and private insurance.
Group 1 indications -- clinical scenarios that frequently support the use of proton therapy based on medical necessity and published clinical data -- were updated with five additions and one modification, ASTRO said.
For group 2 indications, coverage is recommended if the patient is enrolled in either an institutional review board (IRB)-approved study or a multi-institutional registry adhering to Medicare requirements for coverage with evidence development (CED).
