Medicare Announces Expanded PET Coverage
The Centers for Medicare & Medicaid Services (CMS) has issued a national coverage determination (NCD) that expands coverage for FDG-PET scans for the management of cancer patients. The National Oncologic PET Registry has also been extended.
Under this NCD, CMS will cover one (1) FDG-PET study for initial treatment strategy for all types of solid tumors (with the exception of prostate cancer) that are either biopsy proven or strongly suspected based on other diagnostic testing. Coverage limitations remain for breast cancer, cervical cancer and melanoma.
CMS will cover the following indications for subsequent treatment strategy: breast, cervical, colorectal, esophageal, head and neck, lymphoma, non-small cell lung, ovarian, melanoma, myeloma and thyroid. Cervical, ovarian and myeloma are newly covered for subsequent treatment strategy. For subsequent treatment strategy of all other cancers, PET will be covered under an approved Coverage with Evidence Development (CED) program such as the NOPR.
Click on Full Story below to view a chart summarizing the effect of these changes.
Read CMS' Final PET NCD
Read more on SNM Website
View related details on changes to NOPR patient registration and data entry procedures