Medicare Plans To Cover Lung Cancer Screening
Annual low-dose CT lung cancer screening for high-risk individuals will be covered by Medicare, albeit with restrictions, according to a preliminary decision from the agency.
Annual low-dose CT lung cancer screening for high-risk individuals will be covered by Medicare, albeit with restrictions, according to a preliminary decision from the agency. The Centers for Medicare and Medicaid Services (CMS) said that low-dose CT would be reimbursed once per year for beneficiaries who fit the criteria of the pivotal National Lung Screening Trial (NLST): Ages 55-74, at least a 30 pack-year history of smoking, and must be a current smoker or one who quit within 15 years. For the initial screen, the beneficiary would need a written order obtained during a lung cancer screening counseling and shared decision-making visit from a physician, physician assistant, nurse practitioner, or clinical nurse specialist. On subsequent screens, the written order could be from an annual wellness visit, tobacco cessation counseling session, or other visit. Under the preliminary coverage decision, eligible centers would be required to participate in the NLST or be an accredited diagnostic imaging center with training and experience in low-dose CT lung cancer screening (keeping the effective radiation dose under 1.5 mSv). They would also have to participate in a national registry, and submit data on every screen performed.