National Oncologic PET Registry
The Centers for Medicare and Medicaid Services (CMS), a Federal agency that manages the Medicare program, currently pays for PET scans that are ordered for only nine types of cancer and only for certain specific reasons. CMS has a new policy called "coverage with evidence development" (CED) to pay PET scans ordered for most other types of cancer and reasons. This means Medicare will pay for these additional PET or PET/CT scans in the same way that it pays for approved cancers and reasons.
CMS wants to determine if they should pay for PET scans for diagnosis, staging, and treatment monitoring for more types of cancer. In order to collect the information needed to make this decision, CMS will provide payment for the PET scans of patients who are properly registered with the National Oncologic PET Registry (NOPR). In addition, if the patient and their doctor agree to participate in the research, the information will be entered into the registry and will then be analyzed to determine how PET scans affect the way doctors plan treatment for their patients. In order for Medicare to pay for the PET scan, Medicare is requiring that the referring physician provide certain information about the reason for the scan and how the scan results influence treatment. This information will be sent by the PET facility to Medicare as a requirement for payment for the PET scan. Specifically, the NOPR plans to study how PET scans affect the treatment plans of the doctors who order PET scans. Eventually, the results of this research may help to obtain coverage by Medicare and other insurers for a wider range of cancers.
1- All Medicare beneficiaries who are referred for PET for oncologic indications.