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Medicare patients who are at high risk for lung cancer would be able to get screening using low-dose computed tomography under a proposed national coverage decision announced Nov. 10.
“The evidence is sufficient to add a lung cancer screening counseling and shared decision making visit, and for appropriate beneficiaries, screening for lung cancer with low-dose computed tomography, once per year, as an additional preventive service benefit under the Medicare program,” officials from the Centers for Medicare & Medicaid Services wrote in the proposed decision.
The agency would strictly limit eligibility criteria for low-dose CT screening. Appropriate patients would be 55-74 years old, show no signs of lung disease, and have a smoking history of at least 30 pack-years. Further, appropriate patients would be either current smokers or would have quit within the past 15 years. The written order for the low-dose CT screening must come after a lung cancer screening counseling and shared decision making visit with a physician or qualified nonphysician practitioner. Subsequent screenings orders could be received in writing during any appropriate visit.
The proposed coverage national decision comes despite a recommendation from the Medicare Evidence Development and Coverage Advisory Committee earlier this year to not cover low-dose CT screening. A study published Nov. 5 in the New England Journal of Medicine found low-dose CT screening cost effective for patients at high risk for lung cancer (2014;371:1793-802).
CMS will accept comments on the proposed coverage decision for 30 days, starting Nov. 10.
Medicare patients who are at high risk for lung cancer would be able to get screening using low-dose computed tomography under a proposed national coverage decision announced Nov. 10.
“The evidence is sufficient to add a lung cancer screening counseling and shared decision making visit, and for appropriate beneficiaries, screening for lung cancer with low-dose computed tomography, once per year, as an additional preventive service benefit under the Medicare program,” officials from the Centers for Medicare & Medicaid Services wrote in the proposed decision.
The agency would strictly limit eligibility criteria for low-dose CT screening. Appropriate patients would be 55-74 years old, show no signs of lung disease, and have a smoking history of at least 30 pack-years. Further, appropriate patients would be either current smokers or would have quit within the past 15 years. The written order for the low-dose CT screening must come after a lung cancer screening counseling and shared decision making visit with a physician or qualified nonphysician practitioner. Subsequent screenings orders could be received in writing during any appropriate visit.
The proposed coverage national decision comes despite a recommendation from the Medicare Evidence Development and Coverage Advisory Committee earlier this year to not cover low-dose CT screening. A study published Nov. 5 in the New England Journal of Medicine found low-dose CT screening cost effective for patients at high risk for lung cancer (2014;371:1793-802).
CMS will accept comments on the proposed coverage decision for 30 days, starting Nov. 10.
Medicare patients who are at high risk for lung cancer would be able to get screening using low-dose computed tomography under a proposed national coverage decision announced Nov. 10.
“The evidence is sufficient to add a lung cancer screening counseling and shared decision making visit, and for appropriate beneficiaries, screening for lung cancer with low-dose computed tomography, once per year, as an additional preventive service benefit under the Medicare program,” officials from the Centers for Medicare & Medicaid Services wrote in the proposed decision.
The agency would strictly limit eligibility criteria for low-dose CT screening. Appropriate patients would be 55-74 years old, show no signs of lung disease, and have a smoking history of at least 30 pack-years. Further, appropriate patients would be either current smokers or would have quit within the past 15 years. The written order for the low-dose CT screening must come after a lung cancer screening counseling and shared decision making visit with a physician or qualified nonphysician practitioner. Subsequent screenings orders could be received in writing during any appropriate visit.
The proposed coverage national decision comes despite a recommendation from the Medicare Evidence Development and Coverage Advisory Committee earlier this year to not cover low-dose CT screening. A study published Nov. 5 in the New England Journal of Medicine found low-dose CT screening cost effective for patients at high risk for lung cancer (2014;371:1793-802).
CMS will accept comments on the proposed coverage decision for 30 days, starting Nov. 10.
