News | February 20, 2009

AMI Says Prepare for Changes in PET Coverage Under NOPR

February 20, 2009 - The Academy of Molecular Imaging recommends that PET imaging facilities closely monitor NOPR communications and be prepared for coverage changes on the date the final coverage decision is issued.

On January 6, 2009, CMS proposed significant changes to current coverage regarding Medicare's coverage of PET imaging under NOPR (see http://). Under the proposal, Medicare will provide coverage on a routine basis for many of the indications now reimbursed under NOPR. However, other indications would be covered only under a successor Coverage with Evidence Development (CED) program which likely will be somewhat different than the current NOPR program.

Medicare will publish its final coverage statement on or before April 6, 2009. The new policy becomes effective on the day it is published. The NOPR believes it should be possible to have a successor CED program in place when the NCD is published. However, until the day the new NCD is published, we will not know the details of the final coverage policy, whether any new codes or modifiers must be used for claims, nor whether a successor NOPR program has been cleared by CMS.

Although the new coverage policy will be effective on the day it is published, Medicare Contractors are allowed at least 30 days to implement required changes in their claims processing software, and in
their local coverage policies.

Each site should closely monitor NOPR communications, and be prepared for coverage changes on the date the final coverage decision is issued. In the past, when major coverage or fee schedule changes occurred, some providers have held claims until their contractors have implemented the new edits. As soon as additional information becomes available, we will make it available to participating PET facilities via these e-mail announcements and the NOPR website.

For more information: www.ami-imaging.org and www3.cms.hhs.gov/mcd/viewdraftdecisionmemo.asp?id=218

Related Content

International Working Group Releases New Multiple Myeloma Imaging Guidelines

X-ray images such as the one on the left fail to indicate many cases of advanced bone destruction caused by multiple myeloma, says the author of new guidelines on imaging for patients with myeloma and related disorders. Image courtesy of Roswell Park Comprehensive Cancer Center.

News | Computed Tomography (CT) | June 17, 2019
An International Myeloma Working Group (IMWG) has developed the first set of new recommendations in 10 years for...
A high-fidelity 3-D tractography of the left ventricle heart muscle fibers of a mouse

Figure 1. A high-fidelity 3-D tractography of the left ventricle heart muscle fibers of a mouse from Amsterdam Ph.D. researcher Gustav Strijkers.

News | Magnetic Resonance Imaging (MRI) | June 07, 2019
The Amsterdam University Medical Center has won MR Solutions’ Image of the Year 2019 award for the best molecular...
BGN Technologies Introduces Novel Medical Imaging Radioisotope Production Method
News | Radiopharmaceuticals and Tracers | June 05, 2019
BGN Technologies, the technology transfer company of Ben-Gurion University (BGU), introduced a novel method for...
RefleXion Opens New Manufacturing Facility for Biology-guided Radiotherapy Platform
News | Radiation Therapy | May 31, 2019
RefleXion Medical recently announced the opening of its new manufacturing facility at its headquarters in Hayward,...
Study Explores Magnetic Nanoparticles as Bimodal Imaging Agent for PET/MRI

Image courtesy of MR Solutions.

News | PET-MRI | May 23, 2019
Researchers from Bourgogne University in Dijon, France, showed that use of superparamagnetic iron oxide nanoparticles (...
New Phase 2B Trial Exploring Target-Specific Myocardial Ischemia Imaging Agent
News | Radiopharmaceuticals and Tracers | May 17, 2019
Biopharmaceutical company CellPoint plans to begin patient recruitment for its Phase 2b cardiovascular imaging study in...
Blue Earth Diagnostics Expands Access to Axumin in Europe
News | Radiopharmaceuticals and Tracers | May 13, 2019
Blue Earth Diagnostics announced expanded access to the Axumin (fluciclovine (18F)) imaging agent in Europe. The first...
NIH Study of Brain Energy Patterns Provides New Insights into Alcohol Effects

NIH scientists present a new method for combining measures of brain activity (left) and glucose consumption (right) to study regional specialization and to better understand the effects of alcohol on the human brain. Image courtesy of Ehsan Shokri-Kojori, Ph.D., of NIAAA.

News | Neuro Imaging | March 22, 2019
March 22, 2019 — Assessing the patterns of energy use and neuronal activity simultaneously in the human brain improve