Coverage Decision May Jeopardize Image-guided Skin Cancer Treatment: Report

Medicare Administrative Contractors (MACs) are proposing to withdraw insurance coverage for image-guided superficial radiation therapy (IGSRT), according to a news letter from SkinCure Oncology.

IGSRT is an FDA-cleared, noninvasive alternative to Mohs surgery for treating nonmelanoma skin cancers (NMSCs), according to the document, is facing possible exclusion from Medicare coverage across 38 states due to a jointly issued draft Local Coverage Determinations (LCDs) stating that Image-Guided SRT with high-resolution ultrasound (HRUS) provides “no clinical value” due to “insufficient evidence.”

“They overlook more than 20,000 lesion outcomes published in 15 peer-reviewed studies and an independent ECRI review affirming the efficacy of dermal imaging per fraction of SRT delivery for treatment of NMSCs,” the newsletter stated. If finalized, SkinCure said the proposed LCDs would strip Medicare coverage for IGSRT in MAC jurisdictions and could influence private payer policies. 

SkinCure urged dermatologists and stakeholders to advocate for the withdrawal of the draft LCDs and a review process inclusive of dermatologists, radiation oncologists, and patient advocates.

Source: On Point newsletter, by SkinCure Oncology. Issue 09, June 2025.