CMS Expects 'Consistent' Coverage Of Amyloid PET Scans Even Without National Standard

 
• By Cathy Kelly

Medicare has finally rescinded its 10-year-old national restrictions on covering the diagnostic now that advances in amyloid plaque-removing drugs have underscored the importance of PET scans.

PET imaging

The Centers for Medicare and Medicaid Services is retiring a Medicare national coverage determination that only covered amyloid PET scans for Alzheimer’s and dementia patients for use in clinical trials, and will allow its Medicare Administrative Contractors to establish coverage policy on a regional basis going forward, according to a final decision released by the agency on 13 October.

Key Takeaways

  • Medicare is lifting the restrictions on coverage of amyloid PET scans, but declined to establish a new policy mandating broad coverage.

The decision also removes the one scan per patient per lifetime requirement in the NCD. The action confirms a proposed...

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