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CMS has determined that there is sufficient evidence to conclude that the use of osmotic blood brain barrier disruption (BBBD) used as part of a treatment regimen for brain tumors in Medicare beneficiaries is not reasonable and necessary under Section 1862(a)(1)(A) of the Social Security Act.
Accordingly, we are issuing a national coverage determination (NCD) that states:
The use of osmotic blood brain barrier disruption is not reasonable and necessary when it is used as part of a treatment regimen for brain tumors. This NCD does not alter in any manner the coverage of anticancer chemotherapy.
Download entire decision memo.