In a major victory for individuals at high risk for lung cancer, the U.S. Centers for Medicare and Medicaid Services (CMS) released its final decision memo on CT lung cancer screening. The current version contains several changes from last fall’s draft decision memo smokers may now be screened up to age 77 rather than age 74. And the memo was written with a strong emphasis on facilities maintaining a detailed registry of lung cancer patients.
Lung cancer screening that is reimbursed in full by private payors and Medicare will represent a considerable improvement in U.S. healthcare owing to the vast scope of the disease. More than 220,000 people will be diagnosed with lung cancer this year, and more than 160,000 people will die from it “more than breast, colon, and prostate cancers combined,” the American College of Radiology (ACR) noted in a statement. “This proven test, and the access to it that Medicare coverage allows, is a game changer in the battle against lung cancer.”
The CMS memo approves reimbursement of annual lowdose lung cancer screening for asymptomatic individuals ages 55 to 77 years, who have a tobacco smoking history of at least 30 packyears (i.e., one pack per day for 30 years). Screening participants must be a current smoker or have quit within the past 15 years.
Reimbursement will require a “written order” for lowdose CT (LDCT) lung cancer screening that must follow a “lung cancer screening and shared decisionmaking visit furnished by a physician” or a qualified nonphysician practitioner, who may be a physician assistant, nurse practitioner, or clinical nurse specialist, CMS wrote. Subsequent annual screenings must also be accompanied by a written order obtained from a physician, but these orders may be obtained during “any appropriate visit.”
“This is a historic moment for us, since it could result in countless lives being saved from the ravages of lung cancer,” said Dr. Claudia Henschke, PhD, clinical professor of radiology at the Icahn School of Medicine at Mount Sinai and director of the Lung and Cardiac Screening Program at Mount Sinai Hospital, in an email to AuntMinnie.com. “We will continue our research efforts in optimizing the process of CT screening and the subsequent treatment of earlystage lung cancer: In the meantime, we celebrate this important step.”
“This announcement is a remarkable example of how despite many obstacles along the way, researchers, advocacy, and government institutions came together to make the right decision,” Dr. David Yankelevitz, professor of radiology at Icahn School of Medicine, said via email. “This decision has the potential to lead to more lives saved from cancer than anything else for the foreseeable future.”
DIS performs low-dose CT lung screenings at all of our locations. It does, as CMS indicates, requires a referral order from a qualified medical professional. These screening are quick and painless, with the scan taking less than five seconds and total time with CT of about five minutes.