The Centers for Medicare and Medicaid Services proposed to grant routine Medicare payment for numerous cancerrelated FDG-PET applications. Under the proposal, one PET study would be granted for Medicare beneficiaries who have biopsy-proven or strongly suspected solid tumors.
Imaging would be used to determine the location and/or extent of the tumors to guide initial therapy planning, according to CMS.
The proposed coverage determination potentially eliminates the currently rigorous reporting requirements for use of PET for the initial post-diagnostic evaluation of numerous types of cancer, including breast, colorectal, lung, lymphoma, and testicular cancer.
The proposal specifically excludes payment for PET to determine initial antitumor treatment of patients with adenocarcinoma of the prostate, breast cancer, or for imaging the lymph nodes of melanoma patients.