Medicare Benefits Schedule - Item 16050

Administration of Lutetium 177 PSMA, followed within 36 hours by whole body Lu-PSMA SPECT, for treatment of a patient with metastatic castrate resistant prostate cancer who is:

(a) PSMA-positive as determined by PSMA PET (defined as SUVmax >15 at a single site of disease and SUVmax >10 at all sites of measurable disease) after disease progression and

(b) prior treatment includes at least one taxane chemotherapy and at least one androgen receptor signalling inhibitor.

Applicable once per cycle, up to a maximum of 2 cycles in the initial treatment phase.

Fee: $8,000.00 Benefit: 75% = $6,000.00 85% = $7,895.50

(See para TR.3.1 of explanatory notes to this Category)

• Previous - Item 16018
• Next - Item 16055

Medicare benefits for items in Group T3 are only payable when the service is provided by a specialist or consultant physician with training in nuclear medicine.

Related Items: 16003 16006 16009 16012 16015 16018 16050 16055 16060