Strontium Chloride Sr-89 (Metastron) — CPB 0361 | AETNA Coverage Update

Aetna modified CPB 0361 for strontium chloride Sr-89 (Metastron), effective January 11, 2026. Here's what changes for billing teams.

Aetna, a CVS Health company, updated its strontium chloride Sr-89 coverage policy under Clinical Policy Bulletin CPB 0361 Aetna system on January 11, 2026. This radiopharmaceutical treats metastatic bone pain in cancer patients, and the updated criteria now spell out exactly what clinical documentation you need to get claims paid. Precertification is required for all participating providers. If your billing team handles radiation oncology or oncology pharmacy claims, this policy touches a wide range of CPT codes in the 77261–77340 range.

Quick-Reference Table

Aetna Strontium Chloride Sr-89 Coverage Criteria and Medical Necessity Requirements 2026

The Aetna strontium chloride Sr-89 coverage policy sets a two-part test for medical necessity. Both criteria must be met to get initial approval.

First, the member must have a confirmed cancer diagnosis. Second, the member must have bone metastases. That's it — no histology requirements, no performance status thresholds, no prior treatment line restrictions. The criteria are narrow but clean.

Aetna requires precertification for all members on applicable plan designs. Call (866) 752-7021 or fax (888) 267-3277 to initiate. Statement of Medical Necessity forms are available on Aetna's specialty pharmacy precertification portal. Do not skip this step — claims submitted without prior authorization will deny.

For continuation of therapy, Aetna will reauthorize when two conditions are present: no unacceptable toxicity on the current regimen, and documented clinical benefit. Your oncologist's notes need to address both. Vague progress notes will not clear a reauthorization. Make sure your clinical documentation explicitly states the patient is tolerating the drug and responding to it.

For members covered under Medicare, this commercial policy does not apply. Aetna directs those cases to its Medicare Part B criteria separately. If you're billing strontium chloride Sr-89 for a Medicare Advantage member, confirm which criteria set applies before you submit precertification.

The Aetna strontium chloride Sr-89 coverage policy does not list plan-specific exclusions at the CPB level. However, not all commercial plan designs include this benefit. Check the member's specific plan benefits before you order the drug.

Aetna Strontium Chloride Sr-89 Exclusions and Non-Covered Indications

This is the part of the CPB 0361 that will generate the most denials for teams not paying attention.

Aetna considers strontium chloride Sr-89 experimental, investigational, or unproven for all indications except metastatic bone pain in patients with a cancer diagnosis and confirmed bone metastases. That language is a blanket exclusion. There is no off-label carve-out, no compassionate use pathway written into this policy.

The real issue here is that strontium chloride Sr-89 has a history of research use in conditions beyond classic prostate or breast cancer metastases. If a physician orders it for a patient with bone pain from a condition that doesn't meet the two-part criteria — even a condition with published clinical evidence — Aetna will deny it under this policy as experimental.

If your patient population includes atypical indications, talk to your compliance officer before the effective date of January 11, 2026. You need a plan for how to handle those cases.

Coverage Indications at a Glance

Aetna Strontium Chloride Sr-89 Billing Guidelines and Action Items 2026

This policy is active as of January 11, 2026. If you haven't already made these updates, do it now.

CPT, HCPCS, and ICD-10 Codes for Strontium Chloride Sr-89 Under CPB 0361

CPT Codes Associated with This Policy (Related Radiation Oncology Codes)

The policy data includes a broad set of radiation oncology CPT codes listed as related to CPB 0361. These are not exhaustively described in the policy document — they are cited as codes related to the bulletin. The full set spans CPT 77261 through at least 77340 and beyond (316 total CPT codes per Aetna's listing). Below is the documented subset from the provided policy data.

The full policy references 316 CPT codes. The complete list is available in the Aetna CPB 0361 source document. The policy data provided here did not include populated HCPCS or ICD-10-CM code descriptions for this bulletin.

HCPCS Codes

The policy data lists one HCPCS code associated with CPB 0361, but the code value and description were not populated in the source data provided. Pull the full code list directly from Aetna's CPB 0361 source document to confirm the applicable HCPCS code for strontium chloride Sr-89 billing. This is the code you'll need for charge capture — do not assume it matches a common radiopharmaceutical HCPCS code without verifying against the Aetna source.

ICD-10-CM Diagnosis Codes

The policy data references 30 ICD-10-CM codes associated with CPB 0361. Descriptions were not included in the source data provided. Confirm the full ICD-10 list in the Aetna source document before you build your charge capture template. For strontium chloride Sr-89 billing, your diagnosis codes need to reflect both the primary cancer and the bone metastasis — typically pulling from the C-code range for malignant neoplasms and secondary malignant neoplasm codes.