CMS Issues HCPCS Code for Low-Dose Lung Cancer Screening CT

A new HCPCS code (S8032) for low-dose CT for lung cancer screening has been approved was included in the Quarterly Update of HCPCS codes released by CMS  this summer. The addition of the new code is in response to the U.S. Prevention Services Task Force (USPSTF) approving annual lung cancer screening with low-dose CT for individuals at high risk for cancer. The USPSTF gave the test a B ranking, making it eligible for the ACA’s (Affordable Care Act) preventive screening coverage list to be offered to patients by commercial insurers without a copay or deductible. The code will be effective for service dates of October 1, 2014 for private carriers and Medicaid. However, this service is still not covered by Medicare. In the spring of 2014, CMS had received two formal requests to initiate Medicare coverage of lung cancer screening supported by a letter sent to CMS signed by over 40 medical societies recommending coverage of the lung cancer screening CT. In April, MEDPAC (Medicare Evidence Development and Coverage Advisory Committee) voted against recommending the lung cancer screening CT . However, the MEDPAC decision is not binding and CMS is still considering coverage for lung cancer screening. CMS is expected to issue a proposed decision on the issue by November 2014, and a final decision in February 2015.