December 02, 2021

ACR Seeks Modifications to Proposed National Coverage Determination for Lung Cancer Screening

The American College of Radiology® (ACR®) has provided a detailed summary of proposed coverage updates for lung cancer screening to its members. The ACR supports CMS revising its lung cancer screening coverage to reflect the updated U.S. Preventive Services Task Force recommendation, which expands the low-dose CT (LDCT) lung cancer screening risk criteria. We are hopeful proposed changes to the imaging facility requirement will address claims denials for LDCT scans completed in Independent Diagnostic Testing Facilities (IDTFs). We affirm that LDCT LCS is a covered benefit in all facilities, including IDTFs where the LDCT CT exam is performed and interpreted. However, the ACR believes CMS’ proposed coverage updates could lead to unintended consequences and poor quality as this benefit is expanded. Many of the ACR’s recommendations to strengthen coverage as proposed in March and June joint society comment letters have not been incorporated into the proposed decision memo released Nov. 17.

The ACR is working with other provider and patient advocacy groups to ensure quality assurance remains central to new and continued screening programs as LCS is made available to more Americans. The College is preparing comments to CMS on the proposed lung cancer screening changes during the comment period, which ends Dec. 17. ACR members are encouraged to comment to CMS as well. We expect CMS to finalize its coverage decision by Feb. 15.

If you have questions about lung cancer screening coverage or the NCD process, contact Alicia Blakey, ACR Sr. Economic Policy Analyst.