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  • Radiation Therapy Program

    This chapter contains policies and procedures for the EmblemHealth Radiation Therapy Program:

    • Cancer Clinical Pathways
    • Place of service for select outpatient radiation therapy services
    • Prior approval procedures
    • Urgent requests/non-urgent requests
    • Formal dispute resolution
    • CPT code list

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    Glossary terms found on this page:

    Acronym for Medicare Advantage. An alternative to the traditional Medicare program in which private plans run by health insurance companies provide health care benefits that eligible beneficiaries would otherwise receive directly from the Medicare program.

    The process of obtaining advanced approval of coverage for a health care service or medication. The request for services is reviewed to assess medical necessity and appropriateness of elective hospital admissions and non-emergency outpatient services before the services are provided. Also called pre-authorization or pre-certification or pre-determination.

    Treatment of disease by X-ray, radium, cobalt or high energy particle sources.


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