Imaging advocate applauds CMS’ decision to lift longstanding PET payment restriction
The Society of Nuclear Medicine and Molecular Imaging (SNMMI) on Thursday applauded a recent federal decision to lift longstanding restrictions on payment for PET scans.
This noncoverage determination dates to 2000, when the Centers for Medicare and Medicaid Services (CMS) enacted broad, national restrictions for using positron emission tomography scans outside of cancer care. SNMMI and others have lobbied against the change for more than a decade and finally got their wish last week with the release of the 2022 physician fee schedule.
SNMMI President Richard Wahl, MD, said the decision opens a pathway for PET use in assessing cardiac, neurological, infectious, inflammatory and other conditions.
“Removal of the exclusion will enable physicians to base their care decisions on using the right procedure for the right patient at the right time,” Wahl said in a Nov. 11 statement.
The change, set to take effect Jan. 1, 2022, will allow Medicare Administrative Contractors to make decisions about payment for non-oncologic PET use “quickly and effectively.” SNMMI said it is now working with MACs to ensure the coverage rule is implemented properly. It also continues to advocate for the removal of similar noncoverage determinations related to amyloid and NaF PET.
The Medical Imaging & Technology Alliance, which represents imaging manufacturers, also voiced support for CMS’ decision last week.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.