1. Vitiligo Support Group January 13, 2015
Seemal R. Desai, MD, FAAD
Clinical Assistant Professor
Dept of Dermatology
Innovative Dermatology
Plano, TX

2. Phototherapy
Phototherapy or Light Therapy is a service billed to insurance with one of these codes.
96910 code for Narrowband UVB treatment
96920/96921/96922 codes for Excimer laser treatment
Medicare/Medicaid track and make payments based on the above codes
Payment for NB-UVB increased over the past 15 years, except
In 2013, payment was decreased by 9.26%, mainly due to allocation of funds that are no longer part of the Practice Expense, by CMS (Centers for Medicare & Medicaid Services) for non-physician staff
Due to the payment decrease, Phototherapy is under threat, and…therefore treatment for patients suffering from vitiligo

3. Insurance Coverage for Phototherapy and Excimer in Texas
BCBS
YES NO
Cigna
United Healthcare
Aetna
Medicare
**Your dermatologist may need to write a Letter of Medical Necessity

4. Topical Therapies
Some drugs and topical creams still gets denied from insurance coverage, especially when topical steroids have not been tried.
Topical Steroids used to cost less earlier
Clobetasol ointment 60gram costs $ now, used to be approximately $30 for same quantity
GoodRx ( is a great source to check pharmacy prices for medicines in your zip code
No price regulation of generic manufacturers, so prices could rise, and many dermatologists now prescribe brand names as a result.

5. What can you do?
Write to our elected officials and express to them your concern about cuts to Medicare and the SGR(Sustainable Growth Rate)
Use your own example of vitiligo, but needs to be a “global” appeal
Texas Rep Burgess in Denton helped spearhead reform