# Medicare NCD 110.20: blood-brain barrier osmotic disruption for brain tumours

Source: https://onco.cc/terms/medicare-ncd-110-20/  
OnCo record `medicare-ncd-110-20` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Medicare does not pay for opening the blood-brain barrier with an osmotic infusion as part of chemotherapy for brain tumours. Chemotherapy itself remains covered.

## Summary

United States, Medicare National Coverage Determination 110.20, version 1, effective for services on and after 20 March 2007. The NCD explains that the blood-brain barrier can keep anti-cancer drugs out of brain tissue and that disrupting it, most commonly by osmotic infusion, could in theory raise drug concentration in the tumour. It has no nationally covered indications and states that "the use of osmotic BBBD is not reasonable and necessary when it is used as part of a treatment regimen for brain tumors". The NCD "does not alter in any manner the coverage of anti-cancer chemotherapy". Last reviewed March 2007.

## Fields

- Kind: Term
- Last checked: 2026-11-04
- Also known as: NCD 110.20; Blood Brain Barrier Osmotic Disruption for Treatment of Brain Tumors; BBBD
- Tags: us

## Notes

- The NCD covers osmotic disruption only; it says nothing about focused-ultrasound opening, which is linked as the newer approach to the same barrier.

## Sources

- CMS Medicare Coverage Database: the NCD: https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=319&ncdver=1
- CMS Coverage API: the NCD text as data: https://api.coverage.cms.gov/v1/data/ncd?ncdid=319&ncdver=1

## Connected records

- technologies: [Focused-ultrasound blood-brain barrier opening](https://onco.cc/technologies/bbb-focused-ultrasound/)
- cancers: [Brain and spinal cord tumours (all types)](https://onco.cc/cancers/brain-tumours/)
- institutions: [Centers for Medicare & Medicaid Services (CMS)](https://onco.cc/institutions/cms/)
- terms: [Blood-brain barrier (BBB)](https://onco.cc/terms/blood-brain-barrier/)

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