Multiple PET Scans to Detect Alzheimer’s Plaque Allowed Under CMS Policy Change

CMS’s decision to allow coverage of positron emission tomography (PET) agents used to detect amyloid plaque deposits in the brain means patients suspected of having Alzheimer’s may now be covered for more than one PET scan per lifetime, and need not be in a clinical trial to receive the scan.

The decision now permits Medicare Administrative Contractors (MAC) to make coverage determinations for amyloid imaging, according to the agency.

Previously, CMS would only pay for one scan per patient lifetime, and then only in the context of an approved clinical trial. But with the full approval of Eisai’s Leqembi (lecanemab), it became obvious that payers would have to expand coverage, since Leqembi is only indicated for patients with confirmed cerebral amyloid deposits.

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