IDTF and Medicare for Beta Amyloid PET in Dementia and Neurodegenerative Disease
As you know, effective for claims with service dates after 9-27-13, CMS will only allow AB imaging through coverage with evidence of development to develop better treatments or prevention strategies for Alzheimer's Disease or to resolve clinically difficult differential diagnoses. For example, front temporal dementia vs AD where the use of PETAB imaging appears to improve health outcomes when the patient is enrolled in an approved clinical study under CED.
But if you own an IDTF in Florida, the local carrier has been denying claims. This does not facially comport with the national coverage determination. The American College of Radiology needs to clarify this with CMS Baltimore and resolve the issue.