August 22, 2023
On August 16, SNMMI submitted comments to the Centers for Medicare & Medicaid Services (CMS) in response to its proposed removal of its current national coverage determination (NCD) for beta-amyloid PET in dementia and neurodegenerative disease.
SNMMI supports CMS’s proposed updates and agrees with its proposal to remove the NCD, which required coverage with evidence development for beta-amyloid PET. “That is an appropriate action given the importance of Medicare beneficiary access to this minimally invasive, essential procedure and the significance of dementia and neurogenerative disease in the Medicare population,” the Society commented.
For years SNMMI has expressed concern about the NCD, which does not reflect current evidence and which severely limits access to one scan per patient per lifetime. “Given that amyloid presence in the brain may change over time and accurate measurements of beta amyloid are important, Medicare should cover more than one amyloid PET scan in a patient’s lifetime.”
SNMMI concurs with CMS’s view that recent approvals by the Food and Drug Administration of new treatments make amyloid PET even more critical. Amyloid PET is the gold standard for confirming the presence of amyloid in the brain, providing crucial information that could affect the course of treatment.
SNMMI also urged CMS to retire or remove other PET NCDs that are outdated and inappropriately limit coverage.