|
Physician Home | Insurance Coverage Insurance Coverage
Most insurance companies pay for clinically indicated PET and PET/CT procedures. To be clinically indicated, the procedure must be potentially beneficial in providing information supportive of a diagnosis or monitoring certain conditions.
Private Insurance Generally, most private insurance companies cover the same indications as Medicare, although some may cover more indications and some may cover fewer indications. Private payers can have wide variations in coverage policies, coverage criteria or procedures. The referring physician and the imaging center work together to verify specific local coverage guidelines and to obtain pre-authorization prior to performing the scan. Medicare The Centers for Medicare and Medicaid Services (CMS) coverage policies for PET and PET/CT indications are decided at a national level and are documented in a National Coverage Determination (NCD), section 220.6 Medicare Covered Indications. National Oncologic PET Registry (NOPR) The National Oncologic PET Registry (NOPR) was developed in response to the Centers for Medicare and Medicaid Services (CMS) proposal to expand coverage for FDG PET to include cancers and indications not presently eligible for Medicare reimbursement. Medicare reimbursement for these cancers is available if the patient's referring physician and the imaging provider submit data to a clinical registry to assess the impact of PET on cancer patient management. The NOPR implements this registry for CMS. Please contact our office with questions regarding insurance and coverage for PET scans. PET Imaging Institute of South Florida Hollywood 1150 North 35th Avenue, Suite 665 Hollywood, Florida 33021 Tel: 954-981-6668 Fax: 954-450-5944 PET Imaging Institute of South Florida Pembroke Pines 603 N. Flamingo Road, Suite 155 Pembroke Pines, Florida 33028 Tel: 954-450-2202 Fax: 954-450-8401 Center Manager Please contact our Center Manager for any questions related to center operations such as scheduling, billing, exam preparations, and directions. Lisette Cruz-Deno Tel: 954-981-6668 Fax: 954-981-5944 lcdeno@piisf.com Professional Services Coordinator (PSC) Professional Services Coordinators are provided by our center as a non-physician point of contact for referring doctors. Please feel free to contact them to obtain referral pads, journal article reprints and other educational materials related to PET. Erika Thomas Tel: 954-981-6668 Cel: 954-668-5371 Fax: 954-981-5944 erika.thomas@piisf.com Visit http://www.petimagingflorida.com/ |