Policy Name Effective Date Updated Review Date
Radiation Therapy
MP-009 Proton Beam Therapy August 21, 2019 August 21, 2019 August 21, 2020
MP-019 Implanted Intraocular Devices for the Treatment of Glaucoma August 12, 2020 June 12, 2020 June 12, 2021
MP-017 Radioembolization/Selective Internal Radiation Therapy (SIRT) December 16, 2020 December 16, 2020 December 16, 2021