US · guidance
CMS Pub. 100-04, ch. 32, § 180.1
Coverage Requirements
Medicare covers cryosurgery of the prostate gland effective for claims with dates of service on or after July 1,
1999. The coverage is for:
1. Primary treatment of patients with clinically localized prostate cancer, Stages T1 – T3 (diagnosis code is
185 – malignant neoplasm of prostate).
2. Salvage therapy (effective for claims with dates of service on or after July 1, 2001 for patients:
a. Having recurrent, localized prostate cancer;
b. Failing a trial of radiation therapy as their primary treatment; and
c. Meeting one of these conditions: State T2B or below; Gleason score less than 9 or; PSA less
than 8 ng/ml.
History
(Rev. 1111, Issued: 11-09-06, Effective: 04-01-07, Implementation: 04-02-07)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
0bf887568c2b39d46d148a6ef9c5c858bab3b4580335e83f3fdbdb8bfe9ffe32
The link goes to the issuing authority’s own document — the one we read to produce this record. Where a source publishes whole titles rather than sections, your browser may need a moment to jump to the provision.
Unofficial copy of government-published law, reproduced from official sources with full provenance. Not an official publication; verify against official sources before relying on it in a filing. Records in the 'guidance' corpus, and only that corpus, are sub-regulatory (interpretive guidelines, survey procedures) and are not binding law. Validity bounds follow each jurisdiction's declared temporalBasis.