Photodynamic Therapy (cont.)
Gary W. Cole, MD, FAAD
Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What is photodynamic therapy (PDT)?
- What photosensitizer drugs are available?
- What light sources are available, and how are they applied?
- How does photodynamic therapy work?
- Does PDT make me permanently more sensitive to light?
- How is PDT used to treat the skin?
- What is a typical skin PDT session like?
- How much improvement can I expect with photodynamic therapy?
- Where can I have photodynamic therapy, and who performs the procedure?
- What are the advantages with photodynamic therapy for treating actinic keratoses?
- Am I a good candidate for photodynamic therapy?
- What growths is PDT not good for?
- What are possible complications of photodynamic therapy?
- Is there scarring from photodynamic therapy?
- What are alternatives for photodynamic therapy?
- What about insurance coverage and costs of photodynamic therapy?
- How do I prepare for my procedure?
- How is recovery after photodynamic therapy (PDT)?
- Is there pain after PDT?
- How do I take care of my treatment area after photodynamic therapy?
- What is the chance that my actinic keratoses will recur?
- Find a local Dermatologist in your town
What are alternatives for photodynamic therapy?
It is important to understand that as with any medical treatment, there are alternative treatments to PDT. You may want to discuss alternative treatment options with your doctor at your consultation appointment.
There are many options for treatment of an actinic keratosis (AK), including but not limited to freezing (cryotherapy or cryosurgery), burning, chemical peels, creams (like fluorouracil and immune modulator creams like imiquimod), local destruction by curettage and desiccation (scrape and burn), and other choices depending on the skin condition.
In acne, there are many alternatives to PDT, including oral isotretinoin (Accutane), oral antibiotics, topical washes, acne facials, and many acne creams.
What about insurance coverage and costs of photodynamic therapy?
Photodynamic therapy is currently considered a medical service for the treatment of some conditions, particularly for actinic keratosis. However, it may be considered cosmetic, off' label, or not medically indicated for conditions for which it is regularly used.
Currently, some insurance plans cover the procedure under their provided benefits. However, with the many changes in insurance plans, it is always advisable to contact your insurance carrier prior to scheduling any treatment and confirm your eligibility and benefits.
Photodynamic therapy, like any procedure, will result in additional procedure charges above the routine office-visit fees. These fees may range from two to several hundred dollars depending on the area, number of treatments, and the type of insurance you purchase. The greater number of treatments and greater the amount of photosensitizer medication required, the higher the cost.
Insurance benefits vary, and reimbursement depends on what benefits you have contracted for with your insurance company. Currently, Medicare generally typically covers 80% of photodynamic therapy for actinic keratosis. If you have a secondary insurance plan, that may help cover the remaining 20% not covered by Medicare.
Standard commercial or non-Medicare insurances currently generally may cover a large percentage of PDT for actinic kurtosis unless you have to meet an out-of-pocket deductible first. You may want to get to know and understand your insurance benefits before having surgery. In many cases, you may also ask the billing office at the medical center or your insurance coordinator for an approximate estimate of your charges before scheduling the procedure.
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