WASHINGTONMedicare will begin or expand coverage of positron
emission tomography (PET) diagnostic scans for several cancers on July 1. For
the first time, Medicare will cover PET for head and neck cancers, except for
central nervous system and thyroid cancers, and esophageal cancer. Coverage
will apply to diagnosis, staging, and restaging.
Medicare is also expanding PET coverage for four other cancers.
It will now cover diagnosis, staging, and restaging for non-small-cell lung
cancer (NSCLC), colorectal cancer, and lymphoma. Previously, Medicare only
included PET for the initial staging of NSCLC; determining the location of
colorectal tumors if a rising CEA level suggested a recurrence; and the staging
and restaging of lymphoma only when PET was used as an alternative to gallium
In addition, Medicare will cover PET for the diagnosis,
staging, and restaging of melanoma, but not for the evaluation of regional
nodes. Previously it covered PET’s use to evaluate a melanoma recurrence
prior to surgery as an alternative to a gallium scan.
To be eligible for Medicare payment, PET scans for these
approved cancers must use the radiopharmaceutical 18F-fluorodeoxyglucose (FDG),
which is administered intravenously.