SNMMI confirms Medicare reimbursement error for Cerianna

By staff writers

February 24, 2021 -- The Society of Nuclear Medicine and Molecular Imaging (SNMMI) said that the U.S. Centers for Medicare and Medicaid Services (CMS) has confirmed that an inaccurate reimbursement rate had been published in January for Zionexa's Cerianna radiopharmaceutical.

The rate as published in the Hospital Outpatient Prospective Payment System (HOPPS) as of January 2021 was $0.75 per millicurie, but the CMS has confirmed in a correction notice that the correct rate should be $626.58 per millicurie, according to the SNMMI. Any corrections will be retroactive to January 1, according to SNMMI.

The SNMMI has been teaming up with Zionexa to seek proper reimbursement for Cerianna, a radiolabeled F-18 fluoroestradiol radiotracer. Cerianna is indicated for use -- as an adjunct to biopsy -- with PET for detection of estrogen receptor-positive lesions in patients with recurrent or metastatic breast cancer.

Copyright © 2021

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