term sustainability of brachytherapy, it is paramount that we create policies and regulations that ensure that cancer patients receive the best possible care, including consultation on the role of brachytherapy in their treatment. Economic incentives cannot be allowed to drive treatments offered to patients. As a field, we are obligated to support the appropriate training of our young practitioners to increase access to all appropriate radiation oncology treatment options. We must ensure that we are arming our patients with both the knowledge and the power to make informed treatment decisions. Dr. Orio is the Vice Chair of Network Operations, Assistant Professor and Director of Prostate Brachytherapy in the Department of Radiation Oncology at Dana-Farber/Brigham and Women’s Cancer Centers in Boston, Massachusetts. Dr. Viswanathan is a Professor and Interim Chair in the Department of Radiation and Molecular Radiation Sciences at Johns Hopkins. She also serves as the Director of Gynecologic Cancer Radiation and Director of the National Capital Region.ASTRO recognizes that brachytherapy, a highly cost-effective radiation treatment, often faces regulatory barriers that can limit patient access to care. ASTRO’s advocacy teams commit significant resources working to combat the coverage and payment challenges facing brachytherapy.In February, ASTRO issued an update to its brachytherapy model policy —one of five modality-specific model policies that provides recommendations for medical insurance coverage. Please refer to the ASTRO website () to read the Brachytherapy Model Policy, which reflects current evidence, such as clarification confirming the inclusion of the brain in head and neck cancers, as well as the addition of diagnosis codes associated with medical necessity and a statement on electronic brachytherapy. The Brachytherapy Model Policy exhibits what ASTRO believes are the correct coverage policies for brachytherapy and does not serve as a clinical guideline. ASTRO health policy leaders also met with Medicare officials recently as part of an ongoing effort to confront a gross undervaluation of brachytherapy reimbursement in the hospital outpatient setting. ASTRO is asking the Centers for Medicare and Medicaid Services to dramatically revise how they pay for brachytherapy, specifically noting how brachytherapy for cervical cancer is often reimbursed at a level $16,000 below cost. In addition, ASTRO successfully advocated for the Nuclear Regulatory Commission to reform the way it defines medical events for prostate brachytherapy, which had been contributing to a chilling effect among practitioners. Early in 2019, the Commission published a new rule changing the definition to one based on activity, rather than dose.