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Intensity Modulated Radiation Therapy - Medical Clinical …

    https://www.aetna.com/cpb/medical/data/500_599/0590.html
    Aetna considers intensity modulated radiation therapy (IMRT) medically necessary for certain indications where critical structures cannot be adequately protected with standard 3-dimensional (3D) conformal radiotherapy. For medical necessity criteria, …

Proton Beam, Neutron Beam, and Carbon Ion …

    https://www.aetna.com/cpb/medical/data/200_299/0270.html
    Aetna considers proton beam radiotherapy experimental and investigational for all other indications, including the following indications in adults (over age 21) (not an all-inclusive …

Medical Clinical Policy Bulletins - Aetna

    https://www.aetna.com/health-care-professionals/clinical-policy-bulletins/medical-clinical-policy-bulletins.html
    Aetna has reached these conclusions based upon a review of currently available clinical information (including clinical outcome studies in the peer-reviewed published medical …

Stereotactic Radiosurgery - Medical Clinical Policy …

    https://www.aetna.com/cpb/medical/data/1_99/0083.html
    Policy. Aetna considers stereotactic radiosurgery medically necessary in certain circumstances. For medical necessity criteria, see eviCore Healthcare Radiation …

Clinical Policy Bulletin: Intensity Modulated Radiation …

    https://www.aetnabetterhealth.com/pennsylvania/assets/pdf/provider/guidelines/medical/Medical/0590_Intensity%20Modulated%20Radiatino%20Therapy.pdf
    Intensity Modulated Radiation Therapy Revised February 2015 Number: 0590 Policy Aetna considers intensity modulated radiation therapy (IMRT) medically necessary where …

0590 Intensity Modulated Radiation Therapy - Aetna

    https://www.aetnabetterhealth.com/pennsylvania/assets/pdf/pharmacy/pharmacy-bulletins/0590%20Intensity%20Modulated%20Radiation%20Therapy.pdf
    Policy Aetna considers intensity modulated radiation therapy (IMRT) medically necessary where critical structures cannot be adequately protected with …

Intraoperative Radiation Therapy (IORT) - Medical …

    https://www.aetna.com/cpb/medical/data/700_799/0721.html
    Aetna considers intraoperative radiation therapy experimental and investigational for the treatment of the following indications (not an all-inclusive list) because its effectiveness …

Radiation Oncology Solution | Clinical Guidelines - eviCore

    https://www.evicore.com/provider/clinical-guidelines-details?solution=radiation%20oncology&hPlan=Aetna
    The NCCN Guidelines®, NCCN Compendiums® and other content provided by NCCN are works in progress that may be refined as often as new significant data becomes …

Clinical guidelines and policy bulletins - Aetna

    https://www.aetnabetterhealth.com/clinical-guidelines-policy-bulletins.html
    Clinical Guidelines & Policy Bulletins for Medicaid Providers | Aetna Medicaid Login Aetna Better Health® Clinical guidelines and policy bulletins Guidelines We’ve chosen certain …

Intensity-Modulated Radiation Therapy

    https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-medical-drug/intensity-modulated-radiation-therapy.pdf
    Note: This policy applies to persons 19 years of age and older. Intensity-modulated radiation therapy (IMRT) is covered without further review for persons 18 years and …



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