June 12, 2013

CMS bends on oncology PET coverage, will pay for 3 scans

AuntMinnie, June 12th, Brian Casey and Wayne Forrest, Staff writers reported on an announcement by CMS to release some of the restrictions on the use of PET scanning in oncology.  “In a victory for PET proponents, the U.S. Centers for Medicare and Medicaid Services (CMS) on Tuesday issued a final decision on coverage of oncology FDG-PET scans, agreeing to pay for three follow-up studies rather than just one, as it had proposed three months ago.  In a final decision memo announcing the change, CMS said it was responding to comments received since it issued its proposed policy change in March to the national coverage determination (NCD) governing how Medicare pays for oncology FDG-PET scans. CMS had proposed paying for just one initial PET scan for oncology applications and one subsequent scan, with payment for any additional scans to be determined by local Medicare Administrative Contractors (MACs).”