Private Insurance

Most private insurance companies cover the same indications that Medicare covers, but may cover additional indications. In either case, it is prudent to check with the insurance company prior to the PET scan. This Clinical Indications Reference Guide shows applications where PET may be used.

The cost for the PET scan is broken into three components: (1) the FDG radiopharmaceutical, (2) the actual scan, and (3) the professional fee for the physician who reads/interprets the scan.

Most insurance companies require pre-authorization for a PET scan. Physicians routinely provide clinical information to the insurance company to obtain the pre-authorization. Many coverage policies are local, so it is important to determine the coverage policies from your payers.

If private insurance does not cover PET and Medicare is not an option, the patient may want to self-fund the PET scan. Please call us for information about payment arrangements. Patients are responsible for deductibles, co-payments and remaining balances. Payment is expected when services are rendered and all patients are responsible to supply an insurance card and a referral from their Primary Care Physician (if needed).

Please contact our office with questions regarding insurance and coverage for PET scans.

What is PET?

Positron Emission Tomography (PET) is a powerful imaging technique that holds great promise in the diagnosis and treatment of many diseases, particularly cancer. A non-invasive test, PET scans accurately image the cellular function of the human body. In a single PET scan your physician can examine your entire body. PET scanning provides a more complete picture, making it easier for your doctor to diagnose problems, determine the extent of disease, prescribe treatment, and track progress.

What is PET/CT?

PET (Positron Emission Tomography) and CT (Computed Tomography) scans are both standard imaging tools that physicians use to pinpoint disease states in the body. A PET scan demonstrates the biological function of the body before anatomical changes take place, while the CT scan provides information about the body's anatomy such as size, shape and location. By combining these two scanning technologies, a PET/CT scan enables physicians to more accurately diagnose and identify cancer, heart disease and brain disorders.