Medicare Benefits Schedule - Item 16055

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, if:
(a) a service to which item 16050 applies has been provided; and
(b) the patient has not developed disease progression while receiving Lutetium 177 PSMA for this condition.

Applicable once per cycle, up to a maximum of 4 cycles in the continuing 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)

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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