February 24, 2014
The Centers for Medicare & Medicaid Services (CMS) has released instructions to contractors related to its National Coverage Determination for Beta Amyloid PET in Dementia and Neurodegenerative Disease. It is important to note that since there is currently no CMS-approved coverage with evidence development (CED) program in place, these billing instructions for amyloid are not relevant until there is an approved study.
SNMMI, in conjunction with the Alzheimer’s Association, is actively and aggressively working on developing a registry that could be approved by CMS. However, these types of studies often take months to approve and implement. SNMMI will provide additional updates as any completion date gets closer.
Billing instructions for Beta Amyloid PET are similar to the current billing instructions for the ongoing CED program for Sodium Fluoride PET bone imaging.
Further information can be found in CMS Transmittal 164. The CMS Medicare Learning Network also offers a summary.