CMS expands coverage of lung cancer screening with low dose computed tomography

Photo: Prapass Pulsub/Getty Images

 

The Centers for Medicare and Medicaid Services has announced a national coverage determination that expands coverage for lung cancer screening with low dose computed tomography (LDCT).

This final decision expands eligibility for people with Medicare to get lung cancer screening with LCDT by lowering the starting age for screening from 55 to 50 years and reducing the tobacco smoking history from at least 30 packs per year to at least 20 packs per year. 

WHY THIS MATTERS

Lung cancer is one of the most common cancers and the leading cause of cancer-related death in both men and women in the United States. 

The screening will help improve health outcomes for people with lung cancer. It is aimed at early detection of non-small cell lung cancer. 

THE LARGER TREND

The only recommended screening test for lung cancer is LDCT, a unique computed tomography (CT) scan technique that combines special X-ray equipment with sophisticated computers to produce multiple, cross-sectional images of the inside of the body, CMS said.

Based on public comments received on the proposed national coverage determination and additional review, the final decision removes the requirement for the reading radiologist to document participation in continuing medical education, thereby reducing administrative burden on providers. 

CMS also added a requirement back to the NCD criteria for radiology imaging facilities to use a standardized lung nodule identification, classification and reporting system.

The policy simplifies requirements for the counseling and shared decision-making visit, removes the restriction that it must be furnished by a physician or nonphysician practitioner, reduces the eligibility criteria for the reading radiologist, and reduces the radiology imaging-facility eligibility criteria, CMS said.

ON THE RECORD

"Expanding coverage broadens access for lung cancer screening to at-risk populations," said Dr. Lee Fleisher, CMS's CMO and director of the Center for Clinical Standards and Quality "Today's decision not only expands access to quality care but is also critical to improving health outcomes for people by helping to detect lung cancer earlier."

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com