lung cancer screening

The Centers for Medicare and Medicaid Services (CMS) has announced a shift in its eligibility criteria for coverage of lung cancer screening using low-dose CT (LDCT), thus joining other payers in adopting recommendations made by the US Preventive Services Task Force (USPSTF). In addition, CMS made other modifications to its eligibility criteria that will increase the ability of more people to obtain access to screening, effective February 10, 2022 with the posting of its Decision Memo.

While The Centers for Medicare and Medicaid Services (CMS) is considering expansion of coverage for lung cancer screening, a new study shows the effectiveness of early detection in the reduction of lung cancer deaths. Dr. Raja Flores and his colleagues concluded that between 2006 and 2016, lung cancer deaths decreased by about 4% each year. “This decline has been driven by many factors, including smoking cessation, medical therapies, CT screening, and earlier therapeutic interventions,” they reported, and in the conclusion they state that, “our analysis suggests that decreased mortality is also associated with a diagnostic shift from later to earlier stage lung cancer.”

The guideline for LDCT lung cancer screening reimbursement for older adults have changed in recent years. In late 2021 and early 2022, both the U.S. Preventive Services Task Force (USPSTF) and the Centers for Medicare and Medicaid Services (CMS) updated their reimbursement criteria, expanding the age range and smoking history requirements so that more adults can address potential concerns sooner. As a radiology practice, this is important news for how you deliver your services and submit them for reimbursement. Learn more about you need to know with Healthcare Administrative Partners.