CommercialCoverageMedium impact
Hydrogel Spacer Use During Radiotherapy for Prostate Cancer
Blue Cross & Blue Shield of Mississippi·Urology, Oncology, Radiology·Medical Policy
We identified it
Jun 20, 2026
Summary
This Blue Cross Blue Shield policy classifies hydrogel spacer use during radiotherapy for prostate cancer as investigational, meaning it is not covered. Claims for CPT 55874 (transperineal placement of biodegradable material) will be denied as not medically necessary.
Action Required
Immediately: Billing team must flag CPT 55874 as non-covered/investigational in billing system for BCBS plans. Update encounter forms to alert providers that hydrogel spacer procedures (SpaceOAR, Barrigel, BioProtect) are considered investigational by BCBS. Inform patients of potential out-of-pocket costs before procedure. Claims will be denied as not medically necessary.