Traditional MedicareCoverageHigh impact
Superficial Radiation Therapy (SRT) for the Treatment of Nonmelanoma Skin Cancers (NMSC)
Medicare/CMS - LCD·Dermatology, Oncology, Plastic Surgery·Local Coverage Determination
Effective date
Apr 1, 2026
We identified it
Jul 28, 2026
Summary
Wellpoint Federal (MAC Part A and Part B) has issued a new Local Coverage Determination (L40168) effective April 1, 2026, establishing coverage policies and requirements for Superficial Radiation Therapy (SRT) in treating nonmelanoma skin cancers. This is a brand-new policy that billing teams must review immediately to understand covered indications, documentation requirements, and any prior authorization mandates before claims are submitted.
Action Required
By March 31, 2026: Billing team must obtain and review the complete LCD L40168 policy document from the CMS Medicare Coverage Database (https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=40168&ver=9) to identify specific CPT/HCPCS codes covered for SRT procedures, prior authorization requirements, and medical necessity documentation standards. Update billing system rules, claim submission workflows, and provider encounter templates accordingly. Notify all providers and clinical staff who treat nonmelanoma skin cancers of any new documentation or authorization requirements. Implement any required prior authorization processes in the billing software before the April 1, 2026 effective date. Failure to comply with this new coverage policy will result in claim denials for SRT procedures submitted after the effective date.