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Radiation Therapy Services
31.1 Enrollment 31-2
31.2 Benefits, Limitations, and Authorization Requirements 31-2
31.2.1 Clinical Brachytherapy 31-3
31.2.2 Clinical Treatment Planning 31-4
31.2.3 Intensity Modulated Radiation Therapy (IMRT) 31-4
31.2.4 Medical Radiation Physics, Dosimetry, Treatment Devices, and
Special Services 31-4
31.2.5 Noncovered Radiation Therapy Services 31-5
31.2.6 Procedure Code Limitations 31-5
31.2.7 Proton-Beam and Neutron-Beam Delivery 31-8
31.2.7.1 Prior Authorization Requirements 31-8
31.2.8 Radiation Treatment Management and Delivery 31-8
31.2.8.1 Radioisotope Therapy 31-9
31.2.9 Stereotactic Radiosurgery 31-9
31.2.10 Strontium-89 31-10
31.2.11 Technetium TC 99M Tetrofosmin 31-10
31.3 Claims Information 31-10
31.4 Reimbursement 31-11
31.5 TMHP-CSHCN Services Program Contact Center 31-11
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