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ACR is leading national efforts to make prior authorization more efficient and clinically appropriate while reducing the administrative burden and supporting national legislation.
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ACR Submits VCF Time to Treatment Evidence to Commercial Payers
May 15, 2025
The American College of Radiology® (ACR®) joined nine other medical specialty societies whose members utilize and/or perform interventional spine procedures in submitting letters to Aetna, Blue Cross Blue Shield Health Care Service Corporation (BCBS HCSC) and other commercial insurance payers. The letters highlight results from a recent meta-analysis that examined the impact of treatment timing on outcomes for patients with vertebral compression fractures (VCFs) treated using balloon kyphoplasty.
The societies urged commercial payers to align their plans with Medicare’s coverage policies. Existing medical policies are inconsistent with current literature and Medicare coverage policies that expand coverage and allow earlier surgical intervention for the treatment of VCF.
ACR members are encouraged to share recent evidence with their payer to ensure equitable patient access to care regardless of plan type.
If you have questions about this outreach effort or Medicare Coverage processes, contact Alicia Blakey, ACR Principal Economic Policy Analyst.
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