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CMS Proposes to Cover Low-Dose CT Lung Cancer Screening

November 11, 2014



The Centers for Medicare & Medicaid Services (CMS) has proposed that Medicare cover low-dose CT lung-cancer screening (LDCT) for heavy smokers who have undergone a lung cancer screening counseling session with a medical provider. CMS is seeking public comment on the proposal.

 

Highlights of the proposed coverage decision:

 

  • Beneficiaries must be age 55-74, asymptomatic, a current or recent smoker, and must have smoked one pack per day for at least 30 years.
  • Beneficiaries must undergo a lung cancer screening counseling visit that outlines the benefits and risks of screening, as well as other steps patients must take to reduce their risks. This conversation enables “a shared decision” with the medical provider about whether an LDCT is appropriate.
  • LDCT scans would be limited to once per year.
  • Radiologists who perform the scans must be certified and experienced in chest CT scanning.
  • Screening facilities must have participated in past lung cancer screening trials or have experience in LDCT and must collect and submit data to a CMS approved registry. 
 
The CMS decision comes after the agency reviewed recent evidence on LDCT, including an NIH study which showed that people with a history of heavy smoking are 20 percent less likely to die from lung cancer if they are screened with LDCT. In 2014, the US Preventive Services Task Force recommended LDCT annual screening for heavy smokers 55-80 years of age.
 
The proposed decision is available at the CMS website. Click here