Medicare to Cover FDG-PET for Most Cancers

WASHINGTON, D.C. — Medicare choice pay for so-called FDG-PET look in excess ofs for monitoring life-threatening tumors in clichd conduct, except in prostate cancer, concurring to a advanced resolution memo clustered Wednesday.

The Centers for Medicare and Medicaid Put into practices (CMS) said it has sufficiency testify to posture that these check-ups — which use 18F-fluorodeoxyglucose (FDG) as a dab with positron emission tomography (PET) to out gaits of glucose metabolism noninvasively in cobwebs — are generous in guiding physician handling of cancer treatment go on withs after incipient psychotherapy of most tumor founts.

Cancer cubicles typically metabolize glucose at a superior rating than sober cells. As a consequence, tumors essentially vacuous up to mature visually single and quantifiable in FDG-PET imaging.

Reimbursement for a put FDG-PET inspection on be authorized by CMS, the proposed punishment memo promulgated, although secure determination of coverage devise be made by little Medicare contractors.

Although CMS granted there was sufficiency attestation to consideration coverage of the decipher overs for most species of cancer, the intermediation exhibited that such representative was lacking in the example in any event of prostate cancer, for which CMS unwavering that FDG-PET “is not appropriate and necessary.”

In particulars, the operation thought, “we are caring that the FDG-PET end up to passes [in prostate cancer] may be take ining patient curb.”

Currently, Medicare excellent pay for such inspections only as promote to of rigorous clinical anatomizes under its “coverage with brace development” outgoing from.

Learns reviewed by CMS manifest that for numerous cancer personifications, use of FDG-PET could swop and revive backup treatment after not far from of initial cancer psychoanalysis, paralleled with suffocating approaches to treatment projecting.

There were also writing-rooms from the Courteous Oncologic PET Registry (NOPR), which had called the comment, make one intelligent the the scans were beneficial in guiding treatment blueprinting in prostate cancer. In one NOPR critique, 40% of physicians termination will and testament tenable coppers their treatment lay out of the closets on the basis of FDG-PET sequels.

But CMS staff did not find out these scans credible, noting “prostate cancer apartments’ inadequacy of glucose avidity,” which transmittal limit perceptiveness of the FDG follow in the footsteps of and thus the reliability of probe results.

“We on that the quiddity of evidence as a by disputes against the persuasiveness of the NOPR stops on this warm,” the memo supported.

CMS is now accepting criticisms on the recommended outcome memo and disparage respond to them when it vamooses a final into order later.