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Tulsa Pro and Insurance
Seriously considering TULSA PRO. I appear to be a very good candidate due to my localized tumor location in the transitional zone (nearer to the urethra). PSA 4.5, Gleason 3+4=7 in one core, PIRAD 5 spotted on MRI, location is front base left side. Anyways, talking to a couple of centers in Florida that do TULSA PRO one is cash only and other is Mayo Jax. If you’ve done TULSA PRO focal ablation (not whole gland) what was your cost and were you able to get insurance to pay for any of it? If you did it at Mayo Jax did they help you with insurance? It seams to be very pricy at these cash only facilities. Just curious.
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I had Tulsa done at Mayo in Rochester, Minnesota last July. Medicare and my BCBS supplemental insurance covered all the cost. There are official billing codes that started in January of this year, and some insurance companies may now be covering it.
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4 ReactionsI paid $31700 total (pre-visits, anesthesia, tulsa, MRI machine during procedure, post visit), and it was my only option. There are more places now doing Tulsa, and some coding that allows billing insurance in some circumstances (they may not pay all circumstances - as we all know if insurance can get out of paying they will). Mayo knows how to bill, but sometimes insurance can say things like it was not done in a hospital and not pay. I had several other surgeries and most the insurance pays like $100K or $150K and so on, so 31K isn't so huge if you compare it to that but of course it is still a lot of money. I am sure the cash price is up now too, but still worth considering. I opted to not buy a car that year after I had Tulsa and opted to keep my 12 year old car going, but anyway, if you have to cash pay it is tough but at least that option is out there.
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2 ReactionsI believe AQUABLATION is an option if the transition area is the site. As mentioned elsewhere a Dr Helfand in Chicago's North West Hospitals does hypertrophy reduction and anything else in the area too, BPH may have to be a co-diagnosis. Get double reads of mpMRIs and biopsies. AlterraAI does a quick turn around on your biopsy slides. A PSMAPET/CT scan should be done also b/o the P5 on the MRI read,
Are you saying that if the Dr classifies it has a treatment for BPH and prostate cancer that it may be covered? I have had PSMA PET (no spread), CT w/contrast (no spread), and an ArteraAI report (only a 0.7% change of mets after 10 years). Had both AdventHealth in Orlando (who did the biopsy) and Moffitt review biopsy slides and both came back with exact same results. 12 core MRI Guided biopsy with only one core coming back 3+4=7 (70% with 10% being 4)
I had the TULSA partial ablation procedure in 2024 at a private facility in So. California. I paid a flat $30k. Additionally, my original Medicare paid for the required PSMA scan and pre-op exam. This was before Medicare had posted the TULSA procedure codes, so today might be different.