CMS announces coverage of PET for Alzheimer's

Healthcare Financial Management, August, 2004

CMS announced it would cover the use of positron emission tomography (PET) for the diagnosis of Alzheimer's disease (AD). Based on scientific review, CMS determined that use of PET for the diagnosis of suspected AD would be covered for patients when a specific diagnosis remains uncertain despite a thorough clinical evaluation. In addition, Medicare will cover PET in clinical trials on patients with early dementia. However, an expert panel indicated that the evidence supporting the value of PET in early diagnostic evaluation of cognitive impairment is limited. The panel consequently expressed concerns about potential overuse leading to misdiagnosis, unnecessary radiation exposure, and avoidable medical costs. CMS will accept public comments for 30 days on the draft decision for PET coverage of suspected AD and will make the decision final within 90 days.

To read the draft decision memo, go to www.cms.hhs.gov/mcd/viewdraftdecisionmemo.asp?id=104.

To read about the PET coverage change, go to www.cms.hhs.gov/media/press/release.asp? Counters=1092.