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What Does the Future Hold for Medicare Coverage of Amyloid PET Scans?

Diagnostic Imaging

Various organizations have applauded the decision by the CMS to remove National Coverage Determination (NCD) limitations to coverage for amyloid PET scans, including the limitation of Medicare or Medicaid coverage to one PET scan per a patient’s lifetime.

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Study Finds Little Impact of Amyloid PET Scans on Reducing Hospitalization or ER Visits for People with Cognitive Decline

Diagnostic Imaging

In a study of over 25,000 Medicare beneficiaries with mild cognitive decline or dementia, researchers found that obtaining amyloid positron emission tomography (PET) scans resulted in no statistically significant differences upon subsequent hospitalization and emergency department visit rates at one year.

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New CMS plan adds Medicare coverage of PET imaging agents

AuntMinnie

Centers for Medicare and Medicaid Services (CMS) proposed a new reimbursement plan July 10 for diagnostic PET scans that would provide separate payments for radiopharmaceuticals, as well as an extra payment for hospitals when they use domestically produced technetium-99m (Tc-99m).

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CMS lifts limit on amyloid PET coverage

AuntMinnie

Centers for Medicare and Medicaid Services (CMS) announced on October 13 that it has lifted its coverage limit of one beta-amyloid PET scan per lifetime for patients with Alzheimer’s disease. Medicare coverage decisions for amyloid PET scans will now be made by local Medicare Administrative Contractors (MACs).

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CMS proposes new coverage for PET imaging agents

AuntMinnie

Centers for Medicare and Medicaid Services (CMS) proposed a new reimbursement plan July 10 for diagnostic PET scans that would provide separate payments for radiopharmaceuticals, as well as an extra payment for hospitals when they use domestically produced technetium-99m (Tc-99m).

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CMS Proposes Lift of Coverage Restrictions on PET Imaging for Alzheimer's Disease

Diagnostic Imaging

Recognizing the advent of beta amyloid-targeted therapies for the treatment of Alzheimer’s disease, the Centers for Medicare and Medicaid (CMS) has proposed eliminating coverage restrictions that limit amyloid positron emission tomography (PET) scans to clinical trial participants and one amyloid PET scan per lifetime.

Disease 52
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False claims case highlights risky payment arrangements

AuntMinnie

Details of a False Claims Act complaint filed against the former co-owner of a mobile cardiac PET scan operation are a reminder for providers to avoid financial conflicts with respect to the Physician Self-Referral Law, known as the Stark Law. In a news release , the U.S.