The American College of Radiology® (ACR®) submitted comments in response to the Centers for Medicare and Medicaid Services (CMS) National Coverage Analysis (NCA) for Beta Amyloid Positron Emission Tomography (PET) in Dementia and Neurodegenerative Disease (NCD) 220.6.20.
The ACR contends the evidence is sufficient to end the coverage with evidence development (CED) and allow national coverage of beta-amyloid PET. The College strongly urged CMS to reconsider leaving coverage determinations to the discretion of local Medicare Administrative Contractors (MACs) and instead implement a national coverage ruling. If left to local determination, a final ruling for coverage of Aß PET could be significantly delayed and highly variable across geographic regions, further exacerbating existing inequities to access. Swift and broad coverage of Aß PET is imperative at this time when anti-amyloid therapies are being approved by the U.S. Food and Drug Administration (FDA) and highly sought after by patients and their families.
An NCD allowing full coverage without CED would ensure swift and consistent coverage for all Medicare beneficiaries.
ACR will continue to track and monitor policy developments about this clinical topic. The College anticipates a final coverage decision to be released in October. If you have questions regarding NCDs, contact Alicia Blakey, ACR Principal Economic Policy Analyst.