You Be the Expert:
CMS Unleashes PET Coverage
Published on Thu May 01, 2003
Test your knowledge. Determine your solution to this problem before looking at the box below for the answer.
Question: We heard a rumor that CMS plans to expand Medicare's coverage for positron emission tomography (PET) scans. Has CMS released news about PET coverage?
Delaware Subscriber
Answer: CMS is expanding Medicare's PET coverage. On April 16, CMS released an official announcement that it is expanding Medicare PET scan coverage for patients with thyroid cancer and potential cardiac disease. Before the transmittal release, Medicare covered PET scans for the diagnosis, staging and restaging of various cancers, in addition to coverage for myocardial viability and presurgery evaluation of refractory seizures.
Medicare now will also cover:
Ammonia N-13 PET. Physicians can use this test to evaluate a patient for potential cardiovascular diseases, for example, hypertension, coronary artery disease, congestive heart failure and stroke.
PET scans for localizing thyroid cancer.
Medicare decided not to cover the following:
PET scans for soft-tissue sarcoma
PET scans for Alzheimer's disease.
However, CMS is planning an evaluation of PET scans for patients with dementia, as well as Alzheimer's. To read the Medicare press release, go to: http://www.cms.gov/media/press/release.asp?Counter=727.
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