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Medicare Expands Coverage for PET Scans

  • April 22nd, 2003

The Centers for Medicare and Medicaid Services (CMS) has announced that Medicare beneficiaries will now be able to receive coverage of positron emission tomography (PET) to detect and evaluate thyroid cancer and potential cardiac diseases. At the same time, CMS will also evaluate the potential role of PET for patients with suspected dementia.

Currently, Medicare covers PET scans for the diagnosis, staging and restaging of various cancers, including lung, esophageal, colorectal, lympheme, head and neck, and breast. It is also covered for myocardial viability and pre-surgery evaluation of refractory seizures.

Under the recently announced expansion, PET scans may now be used in helping to pinpoint malignant thyroid tumors. In addition, CMS has determined that radiopharmacological ammonia N-13 with PET is useful in evaluating cardiovascular diseases such as hypertension, coronary artery disease, congestive heart failure, and stroke.

Although Medicare currently does not cover PET for evaluating Alzheimer''s disease, CMS is setting up a demonstration project to explore PET''s potential for dementia, and will convene a meeting of experts on this topic.

For the CMS media release on the expansion of coverage for PET scans, click here.

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Last Modified: 04/22/2003

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