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SNMMI Press Releases

June 11, 2013

SNMMI Responds to CMS PET Coverage Decision

SNMMI Responds to CMS PET Coverage Decision

Vancouver, British Columbia – The Society of Nuclear Medicine and Molecular Imaging (SNMMI) applauds the Centers for Medicare and Medicaid Services (CMS) on the ruling issued today on coverage for positron emission tomography (PET) procedures. Focusing on the National Oncologic PET Registry (NOPR), scan limitations and coverage for prostate cancer, the ruling will have a significant impact on patient care, according to the society.

CMS has ruled to end the requirement for coverage with evidence development for scans using 18F-FDG PET under NOPR. The coverage policy will begin immediately, and physicians will no longer have to participate in the NOPR for these procedures to be covered. NOPR will continue, however, for NaF PET scans.

“Since 2009, NOPR has provided the government with a great deal of evidence to prove the effectiveness of the 18F-FDG PETin oncology,” said SNMMI 2013-2014 president, Gary Dillehay, MD, FACR, FACNM. “We are pleased with this decision and will continue working to develop evidence for NaF PET through the NOPR program.”

The CMS ruling also included an increase in the scan limit from one to three scans for subsequent patient management. Subsequent scans will be covered at the discretion of the local Medicare administrative contractors. “We appreciate the fact that CMS has changed the limit from one scan to three,” said SNMMI 2013-2014 vice president-elect, Hossein Jadvar, MD, PhD, MPH, MBA, FACNM. “However, it will be important for the local contractors to allow more than three when clinically necessary.”

Finally, SNMMI was happy with CMS’s ruling that the use of FDG PET/CT to guide treatment for patients with prostate cancer is reasonable and necessary. “Monitoring metastatic prostate cancer therapy can be difficult. However, in some indications PET can provide useful information for physicians in creating an effective treatment plan,” said Dillehay.

SNMMI remains committed to developing appropriate use criteria, creating guidelines and working with CMS and other stakeholders in creating a clear and open dialogue to ensure appropriate utilization of PET by referring physicians, as well as nuclear medicine and molecular imaging professionals.

The society, along with NOPR and Merlino Healthcare Consulting Corp., will host a free webinar, “Positron Emission Tomography Imaging for Solid Tumors Post CMS Final Decision (CAG-00181R4)” on Wednesday, June 19, 2013, from 12:00 – 1:00 pm ET, with more information on this decision. To register, visit https://www2.gotomeeting.com/register/916832410.

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About the Society of Nuclear Medicine and Molecular Imaging

The Society of Nuclear Medicine and Molecular Imaging (SNMMI) is an international scientific and medical organization dedicated to raising public awareness about nuclear medicine and molecular imaging, a vital element of today’s medical practice that adds an additional dimension to diagnosis, changing the way common and devastating diseases are understood and treated and helping provide patients with the best health care possible.

SNMMI’s more than 19,000 members set the standard for molecular imaging and nuclear medicine practice by creating guidelines, sharing information through journals and meetings and leading advocacy on key issues that affect molecular imaging and therapy research and practice. For more information, visit www.snmmi.org.

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