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CMS to Reimburse for NETSPOT

December 13, 2016

NETSPOT® (Ga-68-labeled DOTATATE injection), which identifies somatostatin receptor–positive neuroendocrine tumors (NETs) using positron emission tomography, has been granted “Transitional Pass-Through” status under an “A-code” (A9587) for reimbursement by the Centers for Medicare and Medicaid Services (CMS), effective January 1, 2017. In addition, the same Healthcare Common Procedure Coding System “A Code” will be used on claims to private payers.

NETSPOT is available in two forms: as a drug kit for reconstitution, using a Ga-68 generator, and as a ready-to-use injection delivered from local radiopharmacies in selected metropolitan areas.

The imaging agent was approved by the U.S. Food and Drug Administration in June 2016. It has been used and even paid for over the past six months (prior to issuance of this pass-through code), demonstrating recognition of its value in NET patient management.

Advanced Accelerator Applications Press Release