Insurance Coverage

Most insurance companies pay for clinically indicated PET procedures. To be clinically indicated, the PET scan must be potentially beneficial in providing information supportive of a diagnosis or monitoring certain conditions.

Private Insurance
Most private insurance companies cover the same indications that Medicare covers, but may cover additional indications. In either case, it is prudent to check with the insurance company prior to the PET scan.

Medicare
PET scans are covered by the Centers for Medicare and Medicaid Services (CMS), Medicare, for specific clinical conditions under a National Coverage Determination (NCD).

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 will be available if the patient's referring physician and the provider submit data to a clinical registry to assess the impact of PET on cancer patient management. The NOPR is implementing this registry for CMS.

Please contact our office with questions regarding insurance and coverage for PET scans.

Robert Wood Johnson University Hospital Hamilton

One Hamilton Health Place
Hamilton, New Jersey 08690
Office - 609.584.6612
Fax - 609.584.5817
For more information, or to book an appointment, please call 609.584.6509

Department Hours:
Monday to Friday
7:00 a.m. - 8:00 p.m.

Our Staff:
Rosemary Locastro, MD
Chief Nuclear Medicine Physician

Ryszard Czarnuszewicz, MA,RT,(R)(CV)(M)(QM)
Director of Radiology Services

Steve Wozniak, BS, CNMT, RT(N), PET
Nuclear Medicine Supervisor

Lauren Sabol
Molecular Imaging Coordinator

Robert Wood Johnson University Hospital Hamilton

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