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CMSNational Coverage Determination (NCD)

CMS Treatment of Psoriasis Form


PUVA therapy for Psoriasis

Notes: Reimbursement for PUVA therapy should be limited to amounts paid for other types of photochemotherapy. Payment ordinarily should not be allowed for more than 30 days of treatment, unless improvement is documented.

Indications

(503074) Has the patient's psoriasis not responded to more conventional treatments such as topical steroids, ultraviolet light, or coal tar? 

Contraindications

(503075) Has the Medicare Administrative Contractor documented the patient's unresponsive psoriasis condition prior to seeking coverage for PUVA therapy? 
(503076) Is the PUVA treatment expected to exceed 30 days without documented improvement? 
Effective Date

01/01/2066

Last Reviewed

NA

Original Document

  Reference



Psoriasis is a chronic skin disease, for which several conventional methods of treatment have been recognized as covered. These include topical application of steroids or other drugs; ultraviolet light (actinotherapy); and coal tar alone or in combination with ultraviolet B light (Goeckerman treatment).

A newer treatment for psoriasis uses a psoralen derivative drug in combination with ultraviolet A light, known as PUVA. PUVA therapy is covered for treatment of intractable, disabling psoriasis, but only after the psoriasis has not responded to more conventional treatment. The Medicare Administrative Contractor should document this before paying for PUVA therapy.

In addition, reimbursement for PUVA therapy should be limited to amounts paid for other types of photochemotherapy; ordinarily, payment should not be allowed for more than 30 days of treatment, unless improvement is documented.