The Centers for Medicare and Medicaid Services is allowing Medicare Administrative Contractors (MACs) to cover fluorodeoxyglucose (FDG) positron emission tomography (PET) for infection and inflammation. Members of the American College of Radiology® (ACR®) Contractor Advisory Committee Network, the Commission on Nuclear Medicine and Molecular Imaging, and the Economics Committee on Nuclear Medicine have joined other stakeholders in a unified approach to establishing reimbursement for FDG PET for infection and inflammation.
While ACR and other stakeholders learn how individual MACs wish to proceed, providers may file an appeal if they perform or interpret an FDG PET for infection and inflammation for a Medicare beneficiary and the MAC denies the claim. If you make such an appeal, please email Alicia Blakey, ACR Senior Economic Policy Analyst, at ablakey@acr.org to receive educational resources that may be used to assist the MAC in assessing the evidence for FDG PET for infectious and inflammatory disease indications.
Learn more in the ACR Bulletin article, "A Unified Approach."