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Medicare to boost payment for certain diagnostic imaging agents

Radiology Business

CMS is moving forward with a proposal to issue separate reimbursement for radiopharmaceuticals—a change long lobbied for by the imaging industry.

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GE HealthCare to launch Flyrcado injection in U.S.

AuntMinnie

GE HealthCare's launch coincides with the receipt of pass-through status by the Centers for Medicare & Medicaid Services (CMS), effectiveApril 1st. The company also secured a drug-specific Healthcare Common Procedure Coding System billing code and coverage for traditional Medicare beneficiaries who may be recommended for the injection.

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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 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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CMS' MPFS 2025 final rule includes colorectal cancer screening

AuntMinnie

Centers for Medicare and Medicaid Services (CMS) has released its final rule for the 2025 Medicare Physician Fee Schedule (MPFS), which includes coverage of colorectal cancer screening with CT colonography (CTC) for the first time. Until this past July , the CMS had chosen not to cover CTC for colorectal cancer screening.

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

AuntMinnie

Reshaping the hospital's nuclear medicine and radiopharmaceutical strategy toward theranostics involves intensive and inclusive planning, Beyder explained at SNMMI. Centers for Medicare and Medicaid (CMS) and manufacturers that agree to provide pharmaceuticals at significantly reduced rates for facilities that qualify.