The Centers for Medicare and Medicaid Services (CMS) has proposed to remove the current restriction of coverage to one FDG-PET scan to determine the location and/or extent of a tumor.
In its May 6 announcement, CMS stated that its current restriction "is not supported by the available evidence," and the agency proposes the following:
- The [national coverage determinations] will be changed to remove the current absolute restriction of coverage to "only one" FDG-PET scan to determine the location and/or extent of the tumor.
- CMS will continue to nationally cover one FDG-PET scan to determine the location and/or extent of the tumor.
- Local Medicare administrative contractors will have discretion to cover (or not cover) within their jurisdictions any additional FDG-PET scan.
CMS now will take public feedback on its proposal.
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