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Prior Approval No Longer Required for UVB Light Therapy--Including Home NB-UVB Units

We’d like to remind you that Blue Cross and Blue Shield of North Carolina’s (BCBSNC’s) medical policy for UVB light therapy to treat plaque psoriasis was revised as of July 30, 2013, to no longer require that prior approval be first obtained before home UVB light therapy units will be considered for coverage.  Office-based therapy remains covered as well. 

Prior to being prescribed home UVB light therapy, patients should have failed topical therapy and demonstrate symptom improvement with either initial UVB treatments in the provider’s office or have reported improvement with sun exposure.  If ongoing UVB therapy is determined to be an appropriate treatment for the patient, we want to provide our commercial and State Health Plan members with the choice of either continuing to receive UVB treatments at their provider’s office or purchasing a home narrow-band-UVB unit for their convenience. 

Home UVB therapy is essentially equal in efficacy to the biologics without attendant immune suppression, and can improve patient compliance with prescribed light therapy treatment.  Currently, marketed home UVB units are safe as a result of provider-programmed treatments that prevent overexposure.  Home UVB therapy will also result in significant cost savings for the patient, especially when compared to the costs incurred by being on a biologic drug regimen. 

Please note that it is not BCBSNC’s intent to discourage the use of biologic drugs for those patients who need them; only to provide a safer and more affordable treatment option for both you and your BCBSNC patients to consider.  UVB is not indicated for the treatment of psoriatic arthritis. 

Please advise your patients that National Biological Corporation, the manufacturer of home UVB light therapy units, is the preferred durable medical equipment provider for the purchase of these units.

If you have any questions, please contact the Provider Blue LineSM at 1.800.214.4844.