CMS dropping coverage restrictions around PET imaging outside of oncology care

The Centers for Medicare & Medicaid Services is dropping certain coverage restrictions around PET imaging outside of oncology, a move providers are calling “significant” for the field.

The noncoverage determination dates to 2000, when CMS enacted broad, national restrictions for using positron emission tomography scans outside of cancer care. This forced providers to seek coverage determinations for each individual indication beyond oncology.

Under the recently released 2022 Medicare Physician Fee Schedule, however, CMS is proposing to lift this “outdated” restriction. This would leave coverage decisions tied to non-oncologic PET scans up to each Medicare Administrative Contractor.

Source: https://www.radiologybusiness.com/topics/policy/cms-coverage-restrictions-pet-imaging-oncology