HIFU Treatment does not involve surgery but instead uses a High Intensity Focused Ultrasound (HIFU) beam which safely and effectively destroys the prostate tissue with minimal side effects.
After reviewing the information on this website, you and your family will have a better understanding of prostate cancer treatment options and whether Ablatherm HIFU may be the right prostate cancer treatment for you.
We are still waiting for the final rates from CMS for 2021. The latest rumors are announcing the final rules for early December.
On the physician side, CMS has proposed a total of 29.15 RVUs (this is 30% more than Cryo) and we hope they will go even higher in the final rule. We know AUA and AMA have advocated for this.
We know what the code will be: CPT 55880 - Ablation of malignant prostate tissue, transrectal, with high intensity-focused ultrasound (HIFU), including ultrasound guidance. The good news is that the descriptor includes the word “malignant” which should help make a case for payers to pay this for prostate cancer patients.
With regards to private insurances, this will for sure be a case-by-case discussion at the beginning. We know that Aetna and Cigna have already released a policy where they pay automatically the HIFU procedure in case of recurrence post radiation.