CMS may put oncologic PET coverage in local hands

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The Centers for Medicare & Medicaid Services (CMS) has proposed removing the national noncoverage decision for PET for FDA-approved oncologic applications. If the decision is finalized, local Medicare Administrative Contractors may determine coverage for new oncologic agents within their respective jurisdictions for PET.

The Medical Imaging & Technology Alliance (MITA) applauded the move. “We are encouraged by this first step in removing restrictions for Medicare beneficiaries to access PET procedures. A positive final decision will give cancer patients better access to cutting-edge tools physicians need to diagnose and manage cancer treatment,” said Gail Rodriguez, executive director of MITA, in a press release.

However, the proposal does not address PET tracers for cardiology and neurology. MITA encouraged CMS to expand the proposal to all disease areas appropriate for PET.