publication date: Feb. 6, 2015

Medicare to Begin Coverage of CT Lung Cancer Screening


Computed tomography screening has become a benefit for Americans covered by Medicare.

The Centers for Medicare and Medicaid Services Feb. 5 published a final decision to cover screening of current and former smokers, provided they meet stringent eligibility criteria.

Beneficiaries will go through counseling, health professionals will be required to provide documentation that “shared decision-making” took place, technical criteria for screening will be met, and data will be collected. CMS has never mandated shared decision-making as a gateway to paying for a service.

The agency’s final decision largely follows the draft decision published Nov. 10, 2014 (The Cancer Letter, Nov. 14, 2014).

The age parameters in the final decision are 55 to 77. In the draft decision, the age eligibility was set as 55 to 74, which matched the ages screened in the NCI National Lung Screening Trial.

However, the U.S. Preventive Services Task Force, when it assessed lung screening, relied on modeling to project benefit to a larger age group: ages 55 to 80.

To be eligible, the patients will have to have a 30 pack-year smoking history, be current smokers, or have quit within the past 15 years. A pack-year amounts to smoking one pack per day for a year.

The American College of Radiology Lung Cancer Screening Registry has applied for CMS approval to help providers efficiently meet registry reporting requirements.

 The decision a landmark case in setting payment policy:

• It translates the findings of the NLST, a large randomized trial conducted by … Continue reading 41-05 Medicare to Begin Coverage of CT Lung Cancer Screening

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