CMS Refuses Medicare Coverage of NaF PET Scans

CMS Refuses Medicare Coverage of NaF PET Scans The American College of Radiology (ACR) has joined the World Molecular Imaging Society (WMIS), Society of Nuclear Medicine and Molecular Imaging (SNMMI), and members of the National Oncologic PET Registry (NOPR) Working Group in a public expression of disappointment with a recent decision by the Centers for Medicare & Medicaid Services (CMS) to deny their request to open a reconsideration of the National Coverage Determination (NCD) for 18F-sodium fluoride (NaF) positron emission tomography (PET) scans, a potentially lifesaving cancer-imaging procedure. At the request of CMS, the Journal of Nuclear Medicine published...

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Note:  The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.

Article Overview

This brief news-style article covers a Medicare coverage decision by CMS involving NaF PET imaging, along with the response from radiology and nuclear medicine organizations and a registry working group. It is relevant to readers tracking federal coverage policy, oncology imaging access, and professional society advocacy related to PET services. The article provides a high-level update on the request for reconsideration, the stated CMS response, and the broader implications for clinical utility data collection and coverage access.

Why This Topic Matters

Coverage decisions can directly affect patient access to advanced imaging and determine whether services are reimbursed for Medicare beneficiaries. This update is useful for coding, billing, and compliance professionals who need to stay aware of federal policy changes affecting nuclear medicine and oncology imaging.

What You Will Learn

  • What CMS decided regarding reconsideration of the relevant Medicare coverage policy
  • How professional organizations responded to the coverage decision
  • Why the issue matters for oncology imaging access and Medicare beneficiaries
  • What broader policy or registry activity is associated with the coverage discussion

Who Should Read This

  • Radiology coders
  • Nuclear medicine professionals
  • Hospital billing staff
  • Revenue cycle teams
  • Compliance professionals
  • Healthcare administrators
  • Oncology imaging stakeholders

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