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Final Decision: CMS Covers LDCT Lung Cancer Screening

February 5, 2015

 

The Centers for Medicare & Medicaid Services (CMS) has decided to cover lung-cancer screening with low-dose CT for heavy smokers.  The coverage will begin immediately.

 

A CMS official called the coverage “an important new Medicare preventive benefit since lung cancer is the third most common cancer and the leading cause of cancer deaths in the United States.”

 

Medicare will cover LDCT lung cancer screening once per year for beneficiaries who meet all of the following criteria:

  • Age 55-77 and are either current smokers or have quit smoking within the last 15 years
  • Smoked for at least 30 “pack years” (an average of one pack a day for 30 years) 
  • Received a written order from a physician or qualified non-physician practitioner that meets certain requirements.

 

Coverage also includes a visit for counseling and shared decision-making on the benefits and risks of lung cancer screening, as well as required data collection.  The radiologists and radiology imaging centers that provide the scans must meet specific coverage eligibility criteria, and imaging centers must submit data to a Medicare-approved registry.

 

Click to read CMS coverage decision