HCFA announces FDG payment rate

June 10, 1998

The nuclear medicine community has reason for celebration following the Health Care Financing Administration's June 3 announcement of a national average payment for PET scans. According to ADAC Laboratories of Milpitas, CA, HCFA stated that its Medicare

The nuclear medicine community has reason for celebration following the Health Care Financing Administration's June 3 announcement of a national average payment for PET scans. According to ADAC Laboratories of Milpitas, CA, HCFA stated that its Medicare reimbursement rate would be $1980 for the technical elements of PET imaging, including the isotope F-18 fluorodeoxyglucose (FDG).

The rate pertains to both dedicated PET scanners and coincidence detection gamma cameras. Physician fees will be billed separately and compensated similarly to SPECT scans. HCFA has asked its carriers to apply the rate to all scans since Jan. 1, 1998, the date it made its first statement regarding coverage for lung cancer indications.

The announcement establishes a minimum level of medical care for those covered by Medicare insurance, and makes it unlikely that private carriers will refuse appropriate requests for PET scans, according to executives at cyclotron network operator P.E.T.Net Pharmaceutical Services in Norcross, GA.