On December 16, 2015, CMS issued a National Coverage Determination Decision Memo, declining general Medicare coverage for NaF-18 PET scans to identify bone metastasis of cancer. The procedure will remain covered when conducted as part of a study, under the Coverage with Evidence Development (CED) policy. CMS noted that the test is not therapeutic, but rather only affects the selection of treatment modalities, and “the usefulness of a test result is constrained by the available management alternatives.” CMS extended the CED study period for 24 months, through December 2017.
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CMS Declines Switch from CED to Full Coverage for Imaging to Identify Bone Metastasis of Cancer
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