CMS Posts the Final Decision Memo of the PET NCA Reconsideration

March 8, 2013

On Thursday, March 7, the Centers for Medicare & Medicaid Services (CMS) posted a final decision memo for positron emission tomography (PET). This reconsideration followed the Medical Imaging Technology Alliance’s (MITA) letter to CMS that requested the reconsideration of Section 220.6 of the Medicare National Coverage Determinations Manual, which addresses coverage limitations for PET scans. MITA had asked CMS to remove the current non-coverage language as it pertains to new PET radiopharmaceuticals that receive approval from the Food and Drug Administration.

Following the release of thefinal decision memo, CMS will allow local coverage options for Oncologic Indications of FDA approved PET tracers after September 1, 2013. However, CMS did not follow SNMMI’s recommendationson expandingtheproposal beyond oncology to cover all areas.

SNMMI’s joint letter to CMS, which was submitted with the American Society of Nuclear Cardiology, the American College of Radiology, and the American College of Cardiology, can be found below.