CMS Reverses PET Restriction

by User Not Found | Jul 01, 2013
In March CMS proposed a National Coverage Determination (NCD) that would reduce the number of allowable PET scans to one initial and one subsequent scan.

In March CMS proposed a National Coverage Determination (NCD) that would reduce the number of allowable PET scans to one initial and one subsequent scan. After receiving 175 comments opposing the move, CMS announced on June 11th that they would continue to cover one initial PET scan and three subsequent scans. The medical necessity for any additional scans would need to be determined by the local Medicare Area Contractor (MAC).

Claims for FDG-PET will no longer need to be registered in the National Oncology PET Registry (NOPR) program to be paid, although scans using sodium fluoride (NaF) will still need to follow the NOPR process.

Joe Calandra CMO, Midwest Imaging Professionals
Joe Calandra - CMO, Midwest Imaging Professionals
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