Photodynamic Therapy (cont.)

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What are alternatives for photodynamic therapy?

It is important to understand that as with any medical treatment, there are alternative treatments to PDT. You may want to discuss alternative treatment options with your doctor at your consultation appointment.

There are many options for treatment of an actinic keratosis (AK), including but not limited to freezing (cryotherapy or cryosurgery), burning, chemical peels, creams (like fluorouracil and immune modulator creams like imiquimod), local destruction by curettage and desiccation (scrape and burn), and other choices depending on the skin condition.

In acne, there are many alternatives to PDT, including oral isotretinoin (Accutane), oral antibiotics, topical washes, acne facials, and many acne creams.

What about insurance coverage and costs of photodynamic therapy?

Photodynamic therapy is currently considered a medical service for the treatment of some conditions, particularly for actinic keratosis. However, it may be considered cosmetic, off' label, or not medically indicated for conditions for which it is regularly used.

Currently, some insurance plans cover the procedure under their provided benefits. However, with the many changes in insurance plans, it is always advisable to contact your insurance carrier prior to scheduling any treatment and confirm your eligibility and benefits.

Photodynamic therapy, like any procedure, will result in additional procedure charges above the routine office-visit fees. These fees may range from two to several hundred dollars depending on the area, number of treatments, and the type of insurance you purchase. The greater number of treatments and greater the amount of photosensitizer medication required, the higher the cost.

Insurance benefits vary, and reimbursement depends on what benefits you have contracted for with your insurance company. Currently, Medicare generally typically covers 80% of photodynamic therapy for actinic keratosis. If you have a secondary insurance plan, that may help cover the remaining 20% not covered by Medicare.

Standard commercial or non-Medicare insurances currently generally may cover a large percentage of PDT for actinic kurtosis unless you have to meet an out-of-pocket deductible first. You may want to get to know and understand your insurance benefits before having surgery. In many cases, you may also ask the billing office at the medical center or your insurance coordinator for an approximate estimate of your charges before scheduling the procedure.

Medically Reviewed by a Doctor on 5/5/2014

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