Medicare begins PET reimbursement for segment of Alzheimer's population
The Centers for Medicare and Medicaid Services announced Thursday that it will begin reimbursing PET scans for some patients with suspected Alzheimer's.
The coverage follows a four-year effort to obtain coverage for Alzheimer's scans. It is limited to patients who have atypical symptoms that cannot be clinically distinguished as Alzheimer's or a frontotemporal dementia such as Pick's disease. CMS determined that PET scans would be useful in distinguishing patterns of degeneration between Alzheimer's and the other conditions but stopped short of concluding that such scans could conclusively identify Alzheimer's on its own.
To qualify, patients must have demonstrated cognitive decline for at least six months and show symptoms of both conditions with no clinically clear cause.
When CMS released its draft decision on the subject in June, it rejected PET coverage for patients with mild cognitive impairment or mild dementia, citing lack of evidence in the literature to support PET's role in diagnosis. It did announce, however, that it would fund research to determine what role PET can play in diagnosing those conditions and is developing a study with the National Institute on Aging.
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