News | June 12, 2013

SNMMI Responds to CMS PET Coverage Decision

CMS has ruled to end the requirement for coverage with evidence development for scans using 18F-FDG PET under NOPR

June 12, 2013 — The Society of Nuclear Medicine and Molecular Imaging (SNMMI) says it applauds the Centers for Medicare and Medicaid Services (CMS) on the ruling issued on coverage for positron emission tomography (PET) procedures. Focusing on the National Oncologic PET Registry (NOPR), scan limitations and coverage for prostate cancer, the ruling will have a significant impact on patient care, according to the society.

CMS has ruled to end the requirement for coverage with evidence development for scans using 18F-FDG PET under NOPR. The coverage policy will begin immediately, and physicians will no longer have to participate in the NOPR for these procedures to be covered. NOPR will continue, however, for NaF PET scans.

The CMS ruling also included an increase in the scan limit from one to three scans for subsequent patient management. Subsequent scans will be covered at the discretion of the local Medicare administrative contractors.

Finally, SNMMI said they were happy with CMS’s ruling that the use of FDG positron emission tomography/computed tomography (PET/CT) to guide treatment for patients with prostate cancer is reasonable and necessary.

For more information: www.snmmi.org

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