After nearly decade-long journey, CMS retires coverage barriers for non-oncologic PET scans
The Centers for Medicare & Medicaid Services has dropped coverage barriers for using PET imaging with radiopharmaceuticals during non-oncologic situations, the agency announced recently.
CMS first proposed lifting the long-standing noncoverage determination in July when it released the 2022 Medicare Physician Fee Schedule. Lawmakers made the move official in updates to section 220.6 of the Medicare NCD Manual, leaving coverage decisions for PET scans outside of oncology up to Medicare Administrative Contractors.
The Medical Imaging & Technology Alliance, which had been working with CMS for nearly a decade on the issue, praised the move on Thursday.
“MITA believes this jurisdictional change by CMS will improve beneficiary access to PET imaging for cardiac, neurologic, and other conditions while reducing CMS administrative burdens and allowing for innovative diagnostic tools still in development to get to patients more quickly,” Sue Bunning, the association’s industry director of Molecular Imaging & PET, said in a statement.
The policy change does not apply to beta-amyloid imaging agents, MITA noted, which are commonly used for Alzheimer’s disease therapy. In July, CMS first announced it was assessing whether to launch a coverage determination for beta-amyloid PET scans before filing a formal reconsideration in September.
“MITA supported this reconsideration request and continues to believe that CMS should provide coverage for this critical diagnostic tool for patients suffering from cognitive decline,” Bunning added.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.