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CMS Ends "Coverage with Evidence Development" for PET

June 13, 2013

 

The Center for Medicare and Medicaid services on June 11, 2013, issued its final decision on PET for solid tumors in response to requests that the agency lift its requirement for Coverage with Evidence Development (CED) data collection on PET scans to guide subsequent anti-tumor treatment strategy. The CMS decision involved three key elements:

 

  • CMS ended the CED requirer FDG PET procedures in oncology.CMS allowed three subsequent scans for oment foncologic use to guide anti-tumor treatment strategy after initial anticancer therapy is completed. This is a change from the one scan CMS had allowed in its earlier proposed decision. Coverage of any additional scans would be left to local Medicare contractors.
  • CMS allowed subsequent scans for prostate cancer following initial anticancer therapy. This is a change from CMS’s earlier decision to not allow FDG PET scans for this procedure.

 

The full decision can be found here.