Medicare okays lung cancer screening with Low Dose
Computed Tomography immediately
This is the first time that Medicare has covered lung
5, 2015 - Today the Centers for Medicare & Medicaid Services (CMS)
issued a final national coverage determination that provides for
Medicare coverage of Screening for Lung Cancer with Low Dose Computed
Tomography (LDCT). The coverage - the first ever for lung cancer
screening - is effective immediately.
This is the first time that Medicare has covered
lung cancer screening. This is an important new Medicare preventive
benefit since lung cancer is the third most common cancer and the
leading cause of cancer deaths in the United States, said Dr. Patrick
Conway, chief medical officer and deputy administrator for innovation
and quality for CMS.
Medicare will now cover lung cancer screening with
LDCT once per year for Medicare beneficiaries who meet all of the
● they are age 55-77, and are either current
smokers or have quit smoking within the last 15 years;
● they have a tobacco smoking history of at least
30 pack years (an average of one pack a day for 30 years); and
● they receive a written order from a physician
or qualified non-physician practitioner that meets certain requirements.
Medicare coverage includes a visit for counseling
and shared decision-making on the benefits and risks of lung cancer
screening. The NCD also includes required data collection and specific
coverage eligibility criteria for radiologists and radiology imaging
centers, consistent with the National Lung Screening Trial protocol,
U.S. Preventive Services Task Force recommendation, and multi-society
multi-disciplinary stakeholder evidence-based guidelines.
We believe this final decision strikes an
appropriate balance between providing access to this important
preventive service and ensuring, to the best extent possible, that
Medicare beneficiaries receive maximum benefit from a lung cancer
screening program, Conway said.
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