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NOPR Objective
The goal of the National Oncologic PET Registry is to assess the effect of positron emission tomography (PET) with F-18 fluorodeoxyglucose (FDG) on referring physicians’ plans of intended patient management for those cancers and indications not currently eligible for reimbursement from the Centers for Medicare and Medicaid Services (CMS). Data will be collected from the referring physician before and after the PET study. If complete and timely data are reported to the NOPR within 30 days of the PET scan, the PET facility and interpreting physician (nuclear physician/radiologist) will be eligible for reimbursement by CMS.
Collection of the information required by the NOPR is a condition for reimbursement of the PET scan by the Medicare program for eligible patients. (CMS has designated this mechanism for reimbursement as “coverage with evidence development.”) Such patients would otherwise be required to pay for the PET study themselves, or would not have PET performed at all.
PET Facility Participants
Any PET facility that is approved to bill CMS for either technical or global charges can apply to participate in the NOPR. PET facilities are charged a one time $50 facility registration fee and $50 for each patient entered on the Registry. There is no charge to referring physicians or to patients for registry participation. There is no payment to referring physicians from completion of the required Pre-PET and Post-PET forms.
Patient Eligibility
Medicare beneficiaries who are referred for PET for essentially all oncologic indications that are not currently reimbursable under Medicare (see Indications table for specific exclusions) are eligible to participate in the NOPR.
Referring Physician's Responsibilities
The patient's referring physician must agree to complete Pre- and Post-PET data collection forms that include questions regarding the patient’s planned management.
- The Pre-PET Form must be completed and signed by the referring physician and returned to the PET facility prior to the patient’s PET scan. A blank Pre-PET Form can be downloaded from the NOPR Web site and sent to the PET facility at the time of patient referral. If the form is not submitted with the referral, a patient-specific form can be obtained from the PET facility. The Pre-PET Form can be returned to the PET facility via FAX, mail, or hand delivery.
- After the PET scan is performed, a patient-specific Post-PET Form sent to the referring physician for completion within 30 days. This form can also be returned to the PET facility via FAX, mail, or hand delivery.
The case is eligible for CMS reimbursement only if the Pre-PET Form is completed and returned to the PET facility prior to the PET scan and the Post-PET Form is completed and returned within 30 days of the PET scan.
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