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Proton Beam Radiation Therapy denials: what the review data shows
Independent reviewers have decided 199 published cases where an insurer denied Proton Beam Radiation Therapy — and they overturned the insurer 29.6% of the time. A denial for Proton Beam Radiation Therapy is a starting position, not a final answer.
Published decisions
199
2001–2026
Overturned
29.6%
59 denials reversed
By condition
Published outcomes when Proton Beam Radiation Therapy was denied for these conditions.
| Condition | Decisions | Overturned |
|---|---|---|
| Prostate Cancer | 69 | 5.8% |
| Cancer | 37 | 64.9% |
How to use this in your appeal
These are outcomes from California’s external review program — an independent physician panel that binds the insurer. Every state has an equivalent process, and internal appeals succeed even more often. Cite the outcome record for Proton Beam Radiation Therapywhen you appeal: reviewers routinely find that denials like yours didn’t hold up.
SOURCE: CALIFORNIA DMHC INDEPENDENT MEDICAL REVIEW OUTCOMES (CHHS OPEN DATA) · DERIVED AGGREGATE STATISTICS ONLY · METHODOLOGY
Not legal or medical advice. Coverage Rights is a self-help tool that helps you prepare your own appeal. For advice about your specific situation, talk to a licensed attorney or your doctor.