Stereotactic Radiosurgery and Stereotactic Body Radiotherapy

Patient Selection Criteria Coverage for the use of stereotactic radiosurgery (SRS) using a gamma or linear-accelerator (LINAC) will be considered when any of the following criteria are met:  Arteriovenous malformations;  Acoustic neuromas;  Pituitary adenomas;  Non-resectable, residual or recurrent meningiomas;  Craniopharyngiomas;  Glomus jugulare tumors;  Solitary or multiple brain metastases in patients having good performance status and no active systemic disease (defined as extracranial disease that is stable or in remission);  Primary malignancies of the central nervous system (CNS), including but not limited to high-grade gliomas (initial treatment or treatment of recurrence);  Trigeminal neuralgia refractory to medical management.