Radiopharmaceutical Reimbursement Policy Statement

In April 2008, the SNMMI Board of Directors voted to establish the SNMMI's official position on radiopharmaceutical reimbursement under Medicare. The goal of the policy is to establish our official position on assuring adequate reimbursement for current and new radiopharmaceuticals, and thereby to preserve the future of our specialty.

Summary of SNMMI Approved Radiopharmaceutical Positions:

  1. All radiopharmaceuticals should be recognized and treated as drugs, not supplies.

  2. CMS should continue to reimburse all radiopharmaceuticals at charges reduced to cost in 2008 while working with the nuclear medicine industry (nuclear pharmacies and manufacturers) to develop standard payment methodology based on the average radiopharmaceutical invoice price (RIP) at the distributor or nuclear pharmacy level (patterned similar to average sales price model for traditional drugs).

  3. All radiopharmaceuticals should qualify for the same threshold as all other traditional drugs in 2008 ($60.00, currently) and beyond.

  4. CMS should accept and utilize external data sources to identify and appropriately reimburse radiopharmaceuticals, as CMS does for all other drugs. The most accurate sources of radiopharmaceutical cost data are nuclear pharmacies, distributors, and manufacturers.