Photodynamic Therapy for Malignant Disease 8.01.06
Summary
Excellus medical policy 8.01.06 covers photodynamic therapy (PDT) for malignant disease. PDT with Photofrin is considered medically appropriate for early-stage non-small-cell lung cancer in patients who are ineligible for surgery and radiation, for completely or partially obstructing endobronchial lesions, for palliative treatment of obstructing esophageal cancer, for Barrett's high-grade dysplasia in patients at high risk during prophylactic esophagectomy who decide on this treatment through shared decision-making, and for palliative treatment of unresectable cholangiocarcinoma as an adjunct to stenting. PDT with 5-aminolevulinic acid is considered medically appropriate for superficial and nodular basal cell skin cancer and for Bowen's disease, only when surgery or radiation is contraindicated, and PDT is considered investigational for other malignancies. The current effective date is February 19, 2026, and the April 28, 2026 edit corrected grammatical errors and alphabetized reference entries.
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