Respond Now: Non-coverage of Automated Brain MRI AI Proposal

National Government Services (NGS), a Medicare Administrative Contractor (MAC), proposed a Local Coverage Determination (LCD) that would deny Medicare coverage for Automated Detection and Quantification of Brain MRI technologies (CPT codes 0865T and 0866T). The draft policy would affect clinical practices in Illinois, Minnesota, Wisconsin, Connecticut, New York, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont.

The proposed LCD (DL40332) and accompanying billing article (DA60398) are now open for public comment through March 8. ACR^® encourages members, particularly Neuroradiologists who use these emerging AI enabled MRI tools to review the proposals and consider submitting comments.

NGS will host a public open meeting Feb. 26, 12–2pm ET, to discuss the draft LCD and hear presentations from clinicians, stakeholders and the public. Registration details and the meeting agenda are available online. Anyone wishing to present must submit a written request by Feb. 12.

Celerian Group Company Administrators, LLC, the MAC serving Ohio and Kentucky, stopped covering these services Jan. 19. The MAC’s final LCD and supporting rationale are available to the public.

For more information about LCD activities or questions, contact Alicia Blakey, ACR Manager, Economic Policy.