SUBJECT: Support for Coverage for Magnetic Resonance Image Guided High Intensity
Focused Ultrasound (MRgFUS) for Essential Tremor (ET)
Dear Drs. Patterson and Whites:
On behalf of the American Association of Neurological Surgeons (AANS), the Congress of Neurological
Surgeons (CNS) and the American Society for Stereotactic and Functional Neurosurgery (ASSFN), we
appreciate the opportunity to express our support for the recent formal reconsideration of the Novitas
Local Coverage Decision (LCD) L35094 for Magnetic Resonance Image Guided High Intensity Focused
Ultrasound (MRgFUS) for Essential Tremor (ET) submitted by the University of Pennsylvania Health
System. We urge Novitas to reconsider its policy regarding this procedure and to begin the process of
issuing a positive coverage policy for MRgFUS for the treatment of essential tremor (ET) patients with
medication-refractory tremor.
As you will recall, on November 20, 2018, representatives of the AANS, the CNS and the ASSFN held a
conference call with Dr. Whites, Vicki Kurkland and neurosurgeons from the University of Pennsylvania
to discuss coverage by Novitas for MRgFUS for ET, reported with CPT Category III Code 0398T.
Following that call, leaders of the ASSFN performed a thorough review of published literature on
MRgFUS for ET and developed the attached position paper.
Novitas continues to be an outlier among other Medicare payors regarding coverage for this important
procedure. Currently, five Medicare Administrative Contractors (MACs) provide coverage for MRgFUS.
Neurosurgery has actively participated with several MACs to support coverage for MRgFUS for
appropriately selected patients and provided guidance regarding details of their policies. We welcome
the opportunity to share our expertise on this subject.
The AANS, the CNS and the ASSFN appreciate the opportunity to comment on this issue and to give our
support for the University of Pennsylvania’s request for reconsideration. We strongly recommend that Novitas review the ASSFN position paper and remove MRgFUS from the non-coverage list.
Read full letter here
