Radiation and Oncologic Procedures
UnitedHealthcare Medicare Advantage policy MMP077.14 provides coverage guidance and applicable codes for a range of radiation and oncologic procedures (e.g., high-dose rate electronic brachytherapy, implantable beta-emitting microspheres/TARE/SIRT, transarterial liver therapies, IGRT, standard radiation therapy, PBT, IMRT, SRS/SBRT, IORT). Where Medicare NCDs/LCDs/LCAs exist, compliance is required; where they do not exist, UnitedHealthcare refers to specified commercial policies or InterQual criteria to supplement general NCD guidance.
Coverage Rationale for Transarterial Therapy of the Liver modified to state Medicare has a general NCD for therapeutic embolization (NCD 20.28) but not a specific NCD for TAE or TACE, and to reference InterQual criteria in addition to the NCD.
Language added clarifying UnitedHealthcare's use of InterQual criteria to supplement the Medicare NCD for therapeutic embolization regarding TAE/TACE.
Updated instructions to refer to the UnitedHealthcare Commercial Medical Policy titled Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery for states/territories with no LCDs/LCAs.
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.