Wiki medicare pet scan reimbursement

[kathleeng]

Is anyone familiar with Medicare reimbursing pet scans ie. 78815 and if so, how many do they allow? Our patients are being seen for active, suspected or history of cancers. I'm looking for more information to present to our oncology and hematology doctors, since we have been having issues getting these reimbursed across the board.

 

[trarut]

Take a look at the Medicare NCD for PET scans. https://www.cms.gov/medicare-covera...ails.aspx?NCDId=211&ncdver=3&bc=AgAAgAAACAAA& The document has all the information about covered indications, whether coverage is for diagnosis/staging/restaging, covered/CED/non-covered.

Hope this helps!

 

[kathleeng]

Thank you!

 

[Sullivdr]

220.6.17 CMS don't code for suspect. There are only a few R codes allowed