The Society of Nuclear Medicine and Molecular Imaging lauds last week’s decision by the Centers for Medicare & Medicaid Services (CMS) to remove exclusionary language relating to the non-oncologic use of PET, expanding access to critical care for patients. The change followed 10 years of meetings, letters, and supporting data from SNMMI and its members.
“This decision opens a pathway for patients with cardiac, neurologic, infectious, inflammatory, and other conditions to have nuclear medicine procedures that are highly effective for precision diagnosis of their disease,” says Richard Wahl, MD, president of SNMMI. Nuclear medicine can pinpoint the location and function of specific molecules within the body, often offering physicians information that other available procedures can’t provide.
The change to CMS’s National Coverage Decision 220.6—PET Scans allows decisions about reimbursement for the use of PET for non-oncologic indications to be made quickly and effectively at the discretion of local Medicare Administrative Contractors (MACs), according to SNMMI officials. The new rule will go into effect on Jan. 1, 2022. SNMMI is preparing to work with MACs in a multi-society effort to ensure the smooth implementation of this coverage rule.
“Removal of the exclusion will enable physicians to base their care decisions on using the right procedure for the right patient at the right time,” says Wahl.
SNMMI continues to work with CMS to remove non-coverage decisions for amyloid PET and NaF PET.