Transarterial Radioembolization (TARE)/Selective Internal Radiation Therapy (SIRT) for the Treatment of Malignant Cancers of the Liver (for Tennessee Only)
Effective date
Dec 1, 2026
Identified
Nov 7, 2026
Summary
Effective 2026-12-01, UnitedHealthcare Community Plan of Tennessee revised its Medicaid medical policy for transarterial radioembolization (TARE)/selective internal radiation therapy (SIRT) using yttrium-90 microspheres for liver malignancies, applicable to Tennessee members 19 years of age or older. The proven and medically necessary indications for patients with ECOG status 0, 1, or 2 were updated, most notably changing the uveal melanoma indication to read "metastasis from uveal melanoma when confined to the liver" (previously "uveal/ocular melanoma"), and the TARE definition was updated; all other indications are considered unproven and not medically necessary.
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01By 2026-12-01: Billing team and providers should review the revised list of proven indications for TARE/SIRT with yttrium-90 microspheres for Tennessee Community Plan Medicaid members aged 19 and older, and confirm that the diagnosis and documentation supporting any scheduled TARE/SIRT case match one of the listed indications (including the updated uveal melanoma wording) before scheduling or billing; obtain authorization where required and update charge entry and encounter documentation so claims reflect the supported diagnosis.
02Front desk staff should be told that TARE/SIRT for indications outside the listed set is considered unproven and not medically necessary under this policy, which may result in claim denial.
Original notice
Transarterial Radioembolization (TARE)/Selective Internal Radiation Therapy (SIRT) for the Treatment of Malignant Cancers of the Liver (for Tennessee Only)
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