PET for cervical cancer wins narrow reimbursement

February 18, 2005

The Centers for Medicare and Medicaid Services approved in January a narrow coverage for FDG-PET imaging of cervical cancer. Medicare will reimburse for the initial staging of cervical cancer in a patient with a negative CT or MRI for extrapelvic metastatic disease.

The Centers for Medicare and Medicaid Services approved in January a narrow coverage for FDG-PET imaging of cervical cancer. Medicare will reimburse for the initial staging of cervical cancer in a patient with a negative CT or MRI for extrapelvic metastatic disease.

"We're disappointed the coverage didn't include restaging," said Dr. R. Ed Coleman, president of the Academy of Molecular Imaging. "Referring physicians, however, can send restaging cases to the new national PET data registry, which should be available in the spring."

The American College of Radiology Imaging Network, in conjunction with the AMI, will manage the national registry. The government will monitor the data and make coverage decisions based on the effectiveness of PET in currently uncovered indications.

"If we didn't have the registry, the restrictive cervical cancer approval would be a concern," Coleman said.

Although cervical cancer affects mostly younger women, Medicare approval will make the test more palatable for referring physicians, said Ronald Lissak, owner of Integral PET Associates in New York City.

The industry does a poor job of educating referring physicians, Lissak said. Any legitimacy conferred by the government can help persuade physicians that PET is a valuable test.

Beyond the government's imprimatur, referring physicians need to see more peer-reviewed articles and case studies, and PET imaging needs to be included in more research protocols, he said.

For more information from the Diagnostic Imaging archives:

PET reimbursement depends on clinical trials and data registry

CMS will cover PET in Alzheimer's disease

PET/CT profitability hinges on building the market

PET reimbursement awaits pivotal year in Washington