Appendix E - National Coverage Determinations Manual / NaF-18 PET to Identify Bone Metastasis of Cancer 220.6.19

Why This Topic Matters

Coverage determinations affect whether a service is payable by Medicare and under what circumstances. This article is important for identifying when NaF-18 PET falls within a covered research context versus when it is nationally non-covered, and for understanding the broader policy requirements surrounding the clinical studies referenced by CMS.

Article Sections

1. A. General

   Provides background on PET imaging and the general clinical context for using this type of scan in oncology care.

2. B. Nationally Covered Indications

   Describes the circumstances under which Medicare coverage is available and summarizes the requirements for the referenced prospective clinical study framework.

3. C. Nationally Non-Covered Indications

   States the non-covered policy language and the limits on coverage outside the specified covered context.

4. D. Other

   Notes the radiopharmaceutical agents identified in the policy as covered or non-covered for PET cancer imaging.