Photodynamic Therapy
This Aetna Clinical Policy Bulletin (0375) defines medical necessity criteria, investigational/excluded indications, and coding guidance for photodynamic therapy (topical and intravenous photosensitizers) for commercial medical plans. It includes covered indications (esophageal cancer, lung cancer, certain non-melanoma skin tumors, cholangiocarcinoma) with criteria, lists of covered and not-covered CPT/HCPCS/ICD-10 codes, and background/evidence discussion.
No material clinical or coverage changes in this update.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.