Three imaging organizations are urging the U.S. Centers for Medicare and Medicaid Services (CMS) to reconsider coverage for sodium fluoride (NaF) PET scans.
The Society of Nuclear Medicine and Molecular Imaging (SNMMI), the World Molecular Imaging Society (WMIS), and the American College of Radiology (ACR) are using findings from National Oncologic PET Registry (NOPR) studies as the foundation for their case.
In December 2015, CMS reaffirmed a national coverage determination (NCD) not to reimburse for NaF-PET scans to detect bone metastases. The agency continued the requirement for coverage with evidence development (CED) to allow for additional research on NaF-PET's efficacy.
The SNMMI cited studies published in the Journal of Nuclear Medicine in November and December 2017 as validation that NaF-PET is reasonable and necessary for Medicare beneficiaries.
"We recommend that CMS initiate the reconsideration process for the NCD on PET NaF with a solicitation for public comment," the societies wrote to CMS. "We strongly support covering NaF-PET imaging to identify bone metastases for all oncologic uses when the beneficiary's treating physician determines that the NaF-PET study is needed to inform the initial antitumor treatment strategy or to guide subsequent antitumor treatment strategy after the completion of initial treatment."
