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The rules say that plans must pay for a medical service or item if regular Medicare would pay for it in this case. 
You can find this rule at 42 Code of Federal Regulations (CFR) Section 422.101. 
 
The rules say Indications for SRS/SBRT (for Cranial and Spinal Lesions): 
 
    Primary central nervous system malignancies, generally used as a boost or salvage therapy for lesions < 5 
cm. 
    Primary and secondary tumors involving the brain or spine parenchyma, meninges/dura, or immediately 
adjacent bony structures. 
    Benign brain tumors and spinal tumors such as meningiomas, acoustic neuromas, other schwannomas, 
pituitary adenomas, pineocytomas, craniopharyngiomas, glomus tumors, hemangioblastomas. 
    Cranial arteriovenous malformations, cavernous malformations, and hemangiomas 
    Other cranial non-neoplastic conditions such as trigeminal neuralgia and select cases of medically refractory 
epilepsy. As a boost treatment for larger cranial or spinal lesions that have been treated initially with external 
beam radiation therapy or surgery (e.g. sarcomas, chondrosarcomas, chordomas, and nasopharyngeal or 
paranasal sinus malignancies). 
    Metastatic brain or spine lesions, with stable systemic disease, Karnofsky Performance Status 40 or greater 
(or expected to return to 70 or greater with treatment), and otherwise reasonable survival expectations, OR an 
Eastern Cooperative Oncology Group (ECOG) Performance Status of 3 or less (or expected to return to 2 or 
less with treatment). Note that the higher a Karnofsky Performance Status is, the better a patient is doing. 
However, the lower an Eastern Cooperative Oncology Group (ECOG) Performance Status is, the better a 
patient is doing. 
    Relapse in a previously irradiated cranial or spinal field where the additional stereotactic precision is 
required to avoid unacceptable vital tissue radiation. 
    Choroidal and other ocular melanomas 
 
Limitations for SRS/SBRT (for Cranial and Spinal Lesions): 
 
SRS is not considered medically necessary under the following circumstances: 
 
    Treatment for anything other than a severe symptom or serious threat to life or critical functions. 
    Treatment unlikely to result in functional improvement or clinically meaningful disease stabilization, not 
otherwise achievable. 
    Patients with wide-spread cerebral or extra-cranial metastases with limited life expectancy unlikely to gain 
clinical benefit within their remaining life. 
    Patients with poor performance status (Karnofsky Performance Status less than 40 or an ECOG Performance greater than 3) - see Karnofsky and ECOG Performance Status scales below. Note that the higher a Karnofsky 
Performance Status is, the better a patient is doing. However, the lower an Eastern Cooperative Oncology 
Group (ECOG) Performance Status is, the better a patient is doing. 
    Cobalt-60 pallidotomy is non-covered. 
 
You can find this information in Medicare's Local Coverage Determination (LCD): Stereotactic Radiation 
Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) (L35076). 
 
If you want to read these Medicare rules, you can go to this website www.medicareappeal.com.