Coverage of Conditions and Treatments (Coverage Decisions)
Use this lookup tool to determine coverage decisions, or if prior authorization is needed for the treatment or condition. Note: For Self-insured employer claims, you must contact the employer or their claims administrator.
List also available in PDF format.
See Treatment Guidelines and Resources for additional information.
Tumor treating fields (Optune®, formerly the NovoTTF-100A System or Novocure) is a form of electromagnetic field therapy that uses alternating electrical fields to disrupt cancer cell division. Tumor treating fields have been shown to arrest cell proliferation and destroy cancer cells during division in animal models and human cancer cell lines.
Tumor Treating Fields therapy for treating patients with newly diagnosed or recurrent glioblastoma and other cancers is not a covered benefit. In 2016, the Health Technology Clinical Committee (HTCC) made a non-coverage decision on the device (Novocure). The committee reviewed new evidence about the device in November 2018 and finalized the decision on January 18, 2019. The committee’s determination, based on a systematic review of the evidence of safety, efficacy and cost-effectiveness, is that Tumor Treating Fields is not a covered benefit. Complete information on this HTCC determination is available here: What we're working on | Washington State Health Care Authority.
In adopting this HTCC coverage determination, the Department has concluded that the determination does not conflict with any state statute. Any coverage for investigational treatment would be considered per WAC 296-20-02850. Any coverage for health technologies that have a FDA Humanitarian Device Exemption status would be considered per RCW 70.14.120 (1) (b).