CMS proposes to cover PET for most cancers, prostate excluded

The Centers for Medicare & Medicaid Services (CMS) released a proposed decision memo that outlined its suggestion to cover PET imaging for most solid tumors. CMS noted that PET monitoring of Medicare beneficiaries with prostate cancer is not reasonable and necessary.

The proposal would end the coverage with evidence development requirement for PET imaging of oncologic indications and halt the requirement for prospective data collection by the National Oncologic PET Registry (NOPR). 

CMS seeks to approve PET imaging to guide physician management following initial treatment, with the exception of prostate cancer. Thus, local Medicare Administrative Contractors would make coverage decisions regarding additional PET scans to inform decision making after initial treatment, prostate cancer excluded.

To read and comment on the proposed decision memo, click here.