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Physician Home | Insurance Coverage Insurance Coverage
Most insurance companies pay for clinically indicated PET procedures. To be clinically indicated, the PET scan must be potentially beneficial in providing information supportive of a diagnosis or monitoring certain conditions.
Private Insurance Most private insurance companies cover the same indications that Medicare covers, but may cover additional indications. In either case, it is prudent to check with the insurance company prior to the PET scan. Medicare PET scans are covered by the Centers for Medicare and Medicaid Services (CMS), Medicare, for specific clinical conditions under a National Coverage Determination (NCD). National Oncologic PET Registry (NOPR) The National Oncologic PET Registry (NOPR) was developed in response to the Centers for Medicare and Medicaid Services (CMS) proposal to expand coverage for FDG-PET to include cancers and indications not presently eligible for Medicare reimbursement. Medicare reimbursement for these cancers will be available if the patient's referring physician and the provider submit data to a clinical registry to assess the impact of PET on cancer patient management. The NOPR is implementing this registry for CMS. Please contact our office with questions regarding insurance and coverage for PET scans.
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