In a recent decision from the Centers for Medicare and Medicaid services, PET scans used to gauge a patient’s myocardial viability will now be covered. PET scans will be covered: as a primary or initial diagnostic study to determine myocardial viability prior to revasularization; or following an inconclusive single photon emission computed tomography (SPECT) test.
Medicare will also continue to cover SPECT as an initial testing, but will not pay for SPECT when used as a follow-up to an inconclusive PET scan because of PET’s “greater specificity,” according to CMS. Physicians won’t begin to see payment for these services until CMS issues transmittals that officially update both the Coverage Issues Manual and Medicare Carriers Manual. This process may take a few weeks to several months to complete.
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