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Tumor Treatment Field Therapy (TTFT)

LCD L34823 · 8 versions, 2015 to today · last changed 2020-01-01 (R8)

Version 10 of LCD L34823: in force by CMS's dates 2016-07-01 to 2016-06-30. The policy text on this page comes from this archived version.

DME MAC jurisdictions
JA · Noridian 16013
CT, DE, DC, ME, MD, MA, NH, NJ, NY, PA, RI, VT
JB · CGS 17013
IL, IN, KY, MI, MN, OH, WI
JC · CGS 18003
AL, AR, CO, FL, GA, LA, MS, NM, NC, OK, PR, SC, TN, TX, VI, VA, WV
JD · Noridian 19003
AK, AS, AZ, CA, GU, HI, ID, IA, KS, MO, MT, NE, NV, ND, MP, OR, SD, UT, WA, WY
source

CMS's Who are the MACs jurisdiction pages (DME facts as of 2025-09-30) name each contractor and its states; the MCD's Contractor Information table on every DME LCD prints the contract numbers. Both read 2026-10-09. Verzi adds the state lookup only.

You are viewing version 10 (2016-07-01, superseded same day). Version 27 is in force today.

Codes CMS lists in this LCD's current version (version 27, 2 codes). CMS's download carries no list for version 10: A4555 E0766

Sections in this version: Coverage Indications, Limitations, and/or Medical Necessity · Coding Information · Associated Information · Sources of Information and Basis for Decision. Plus 4 sections marked N/A in this version.

Full verbatim text serves to customers · Customer? Log in

Version history, LCD L34823

CMS numbers each version. Each box shows the version's window by CMS's stated dates. Select a version to show it on this page. Versions superseded the same day they took effect never governed a claim, so the page hides them until you ask. Version numbers CMS never published to its archive do not exist as documents.

v22015-10-01, superseded same dayv62015-10-01 to 2016-06-30v92016-07-01, superseded same dayv102016-07-01, superseded same dayv122016-07-01 to 2016-12-31v142017-01-01 to 2019-08-31v232019-09-01 to 2019-12-31v272020-01-01 to today

Revision history, every version

CMS's own change log, quoted, 7 entries. It does not change with the version shown. A revision (R-number) is a change CMS logged. The version (vN) is the snapshot that carries it.

R8 · 2020-01-01 · v27
Revision Effective Date: 01/01/2020
COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Revised: “face-to-face” to “in-person”, where applicable
Revised: Order information as a result of Final Rule 1713
CODING INFORMATION:
Removed: Field titled “Bill Type”
 Removed: Field titled “Revenue Codes”
Removed: Field titled “ICD-10 Codes that Support Medical Necessity”
Removed: Field titled “ICD-10 Codes that DO NOT Support Medical Necessity”
Removed: Field titled “Additional ICD-10 Information”
DOCUMENTATION REQUIREMENTS:
Revised: “physician’s” to “ treating practitioner’s”
GENERAL DOCUMENTATION REQUIREMENTS:
Revised: Prescriptions (orders) to SWO


02/27/2020: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because they are due to non-discretionary coverage updates reflective of CMS FR-1713.
R7 · 2019-09-01 · v23
Revision Effective Date: 09/01/2019
COVERAGE INDICATIONS, LIMITATIONS, AND/OR MEDICAL NECESSITY:
Added: Criteria for Initial Coverage for Newly Diagnosed Glioblastoma Multiforme
Added: Criteria for Continued Coverage for Newly Diagnosed GBM Beyond the First Three Months of Therapy
Added: Coverage statement for Recurrent GBM
Added: Coverage statement for Other Uses
Added: Beneficiaries Entering Medicare FFS requirements
SUMMARY OF EVIDENCE:
Added: Summary of evidence reviewed
ANALYSIS OF EVIDENCE (RATIONALE FOR DETERMINATION):
Added: Background, CAC and key question information, and Conclusion
HCPCS CODES:
Added: HCPCS Modifiers GA, GZ, KF, and KX
SOURCES OF INFORMATION:
Added: References to sources of information
BIBLIOGRAPHY:
Added: Bibliography information
RELATED LOCAL COVERAGE DOCUMENTS:
Added: Response to Comments: Tumor Treatment Field Therapy (TTFT) – DL34823
R5 · 2017-01-01 · v14
Revision Effective Date: 01/01/2017
COVERAGE INDICATIONS, INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Added: New reference language and directions to Standard Documentation Requirements
Added: General Requirements
DOCUMENTATION REQUIREMENTS:
Added: General Documentation Requirements
Added: New reference language and directions to Standard Documentation Requirements
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Added: Direction to Standard Documentation Requirements
Removed: PIM reference from Appendices
SOURCES OF INFORMATION AND BASIS FOR DECISION:
Removed: Sources of Information
RELATED LOCAL COVERAGE DOCUMENTS:
Added: LCD-related Standard Documentation Requirements article
R4 · 2016-07-01 · v12
Revision Effective Date: 07/01/2016
Links for Sources of Information and Basis for Decision updated.
R3 · 2016-07-01 · v10
Revision Effective Date: 07/01/2016
Links for Sources of Information and Basis for Decision updated.
R2 · 2016-07-01 · v9
Effective July 1, 2016 oversight for DME MAC LCDs is the responsibility of CGS Administrators, LLC 18003 and 17013 and Noridian Healthcare Solutions, LLC 19003 and 16013. No other changes have been made to the LCDs.
R1 · 2015-10-01 · v6
Draft promoted to final.
Receipts for auditors

Version 10 of LCD L34823, shown on this page: in force by CMS's dates 2016-07-01 to 2016-06-30. Archived 2026-09-26. CMS's copy · Our archived file. 8 of 8 sections are proven word-identical to the archived file.

Every archived version of LCD L34823 (8 versions, CMS's dates, window by the as-of rule). The Article rows are the Article versions in force on the start dates of these LCD versions.

DocumentVersionIn forceArchived onVerify
LCD L34823version 22015-10-01, superseded same day2026-09-26CMS's copy · Our archived file
LCD L34823version 62015-10-01 to 2016-06-302026-09-26CMS's copy · Our archived file
LCD L34823version 92016-07-01, superseded same day2026-09-26CMS's copy · Our archived file
LCD L34823version 10 shown2016-07-01, superseded same day2026-09-26CMS's copy · Our archived file
LCD L34823version 122016-07-01 to 2016-12-312026-09-26CMS's copy · Our archived file
LCD L34823version 142017-01-01 to 2019-08-312026-09-26CMS's copy · Our archived file
LCD L34823version 232019-09-01 to 2019-12-312026-09-26CMS's copy · Our archived file
LCD L34823version 272020-01-01 to today2026-09-26CMS's copy · Our archived file
Article A52711version 62015-10-01 to 2016-06-302026-09-26CMS's copy · Our archived file
Article A52711version 82016-07-01 to 2016-12-312026-09-26CMS's copy · Our archived file
Article A52711version 102017-01-01 to 2019-08-312026-09-26CMS's copy · Our archived file
Article A52711version 162019-09-01 to 2019-12-312026-09-26CMS's copy · Our archived file
Article A52711version 222020-01-01 to today2026-09-26CMS's copy · Our archived file
Article A55426version 122017-01-01 to 2017-04-192026-09-26CMS's copy · Our archived file
Article A55426version 622019-01-01 to 2019-12-312026-09-26CMS's copy · Our archived file
Article A55426version 722020-01-01 to 2020-04-052026-09-26CMS's copy · Our archived file

Each archived file's page gives its sha256 fingerprint. A copy of the file hashes to the same value, byte for byte.

CMS's live page shows only the current version. To check a passage by eye, open CMS's copy of the same version number. A version's window ends on the earlier of CMS's stated end date and the day before the next version starts.

Every policy word on this page is CMS's, from the archived version named beside it. Verzi adds labels, highlights, citations and links only. Verzi-written summary content on this page: none.