Table 1.

CMS coverage for FDG-PET in oncology

Clinical conditionCoverage (effective date)
Solitary pulmonary noduleCharacterization (January 1998)
Lung cancer (NSCLC)Initial staging (January 1998)
Diagnosis, staging, and restaging (July 2001)
Esophageal cancerDiagnosis, staging, and restaging (July 2001)
Colorectal cancerTumor localization if carcinoembryonic antigen suggests recurrence (July 1999)
Diagnosis, staging, and restaging (July 2001)
MelanomaEvaluating recurrence as an alternative to gallium scan (July 1999)
Diagnosis, staging, and restaging (July 2001)
LymphomaStaging and restaging as an alternative to gallium scan (July 1999)
Diagnosis, staging, and restaging of Hodgkin's and non-Hodgkin's (July 2001)
Head and neck cancer (excluding central nervous system and thyroid)Diagnosis, staging, and restaging (July 2001)
Breast cancerAdjunct for diagnosis, staging, restaging, and monitoring response (October 2002), particularly as an adjunct for staging metastatic disease, restaging locoregional recurrence or metastasis, and monitoring response of locally advanced and metastatic breast cancer when a change in therapy is anticipated
Thyroid cancer (follicular cell)Evaluating recurrent or residual follicular cell tumors (treated previously by thyroidectomy and radioiodine ablation) when serum thyroglobulin >10 ng/mL and 131I whole-body scan is negative (October 2003)
Cervical cancerDetecting pretreatment metastases in newly diagnosed cervical cancer after negative conventional imaging (January 2005)