CMS to cover PET for Alzheimer's

In a major win for PET advocates, the U.S. Centers for Medicare and Medicaid Services (CMS) has expanded Medicare coverage of PET to include some Medicare beneficiaries with suspected Alzheimer's disease. The agency will also include other beneficiaries at risk for Alzheimer's disease (AD) who are enrolled in a large and easily accessible clinical trial.

The agency's national coverage decision (NCD) expands the coverage of PET to include beneficiaries who meet the diagnostic criteria for both AD and frontotemporal dementia, who have been evaluated for specific alternate causes of dementia, and for whom the cause of the clinical symptoms remains uncertain, CMS said. 

Medicare beneficiaries who meet specific criteria may participate in a clinical trial and receive a PET scan while CMS continues to review evidence about the benefits of these scans in additional populations. The agency will also support the conduct of additional studies that will determine the value of PET scans required in a broader population of Medicare beneficiaries who develop symptoms of dementia, according to Dr. Sean Tunis, CMS chief medical officer.

The decision memorandum is available on the CMS Web site.

By staff writers
September 17, 2004

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CMS to reimburse PET for Alzheimer's, June 16, 2004

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