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CMS Adjusts Nuclear Medicine Reimbursement Policy, Expanding Access to Life-Saving Scans

Imaging Technology

1, 2024 — The Centers for Medicare & Medicaid Services (CMS) have announced a significant adjustment to the Hospital Outpatient Prospective Payment System (HOPPS). However, under the previous reimbursement system, diagnostic radiopharmaceuticals were bundled as “supplies,” limiting access in several ways.

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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 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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Imaging societies' reactions mixed on finalized MPFS, HOPPS rules

AuntMinnie

Centers for Medicare & Medicaid Services (CMS) 2025 Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (HOPPS) final rules. ASTRO also supports short-term relief established through the Medicare Patient Access and Practice Stabilization Act, which would eliminate the looming 2.8%

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The rise of theranostics: Part 5 -- Advice from center administrators

AuntMinnie

As nuclear medicine therapies gain stature compared to nuclear medicine in diagnostic imaging, hospital administrators may be eyeing the potential of adding theranostics services. A shortage of nuclear medicine technologists means a theranostics center may need to limit its patient volume.

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Nuclear cardiology could face cuts in 2025

AuntMinnie

Nuclear cardiologists could see significant reductions in Medicare reimbursements in 2025, according to a leading expert. Nuclear cardiologists need to be aware of the potential negative financial impact and plan accordingly, Phillips said. Despite a proposal by the U.S.

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Unlocking the potential of imaging in Alzheimer’s disease care

AuntMinnie

Centers for Medicare and Medicaid Services (CMS), for example, did not cover amyloid PET scans outside of clinical trials for Medicare beneficiaries and only covered one scan per patient’s lifetime. Reimbursement barriers Unfortunately, until recently, there were significant barriers to receiving amyloid PET imaging in some regions.

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