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Transarterial Radioembolization (TARE)/Selective Internal Radiation Therapy (SIRT) for the Treatment of Malignant Cancers of the Liver (for New Mexico Only)
Act
by Nov 1, 2026
Effective date
Dec 1, 2026
Identified
Oct 3, 2026
Summary
UnitedHealthcare Community Plan of New Mexico revised its coverage policy for TARE/SIRT (yttrium-90 microspheres) for liver cancer treatment, effective December 1, 2026. The key change replaced "metastasis from uveal/ocular melanoma" with "metastasis from uveal melanoma" in the list of covered indications. The policy also updated definitions and clinical evidence sections. Coverage applies to patients 19+ years with ECOG Performance Status 0-2; patients under 19 are automatically covered without prior review.
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What to do
by Nov 1, 2026 · 6 steps
01Billing and clinical teams must update internal coverage guidelines and prior authorization protocols for TARE/SIRT procedures in the billing system and EMR.
02Update documentation templates to reflect the revised indication list, specifically replacing "uveal/ocular melanoma" with "uveal melanoma" for coverage validation.
03Train prior authorization reviewers that patients under 19 years old require no prior review authorization.
04Ensure all claims submitted on or after December 1, 2026 reference only the six covered indications listed in the revised policy.
05Claims citing non-covered indications will be denied.
06This applies only to New Mexico Medicaid patients.
Original notice
Transarterial Radioembolization (TARE)/Selective Internal Radiation Therapy (SIRT) for the Treatment of Malignant Cancers of the Liver (for New Mexico Only)
uhcprovider.com · Always check the source before changing claims.
Related changes
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