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NOPR Background
The National Oncologic PET Registry (NOPR) was developed in response to the Centers for Medicare and Medicaid Services
(CMS) proposal to expand coverage for positron emission tomography with F-18 fluorodeoxyglucose (PET) to include cancers and indications not presently eligible for Medicare reimbursement. Medicare reimbursement for these cancers can now be obtained if the patient's referring physician and the provider submit data to a clinical registry to assess the impact of PET on cancer patient management. The NOPR is implementing this registry for CMS. The NOPR is sponsored by the Academy of Molecular Imaging
(AMI)and managed by the American College of Radiology
(ACR) through the American College of Radiology Imaging Network(ACRIN).
The NOPR received input from, and is endorsed by the ACR, the American Society for Clinical Oncology
(ASCO), and the Society for Nuclear Medicine
(SNM).
NOPR Status Update
The NOPR officially began accepting patient registrations on May 8, 2006. During
nearly three years of operation, over 100,000 patients have undergone PET under
NOPR’s mechanism that allows for Medicare coverage of these scans. The NOPR
investigators have published several peer-reviewed manuscripts
documenting the impact of PET on referring physicians’ intended management in
patients with cancer. Based in part on these results, the NOPR investigators
asked CMS in March 2008 to reconsider its coverage policy for PET. On April 3,
2009, CMS announced a new coverage policy. Under this new policy, CMS
expanded coverage for the use of PET for initial evaluation of patients with
cancer to nearly all types of cancer and also allows for use of PET in
subsequent treatment strategy evaluations for an expanded number of cancers.
However, for many other cancers, the use of PET in subsequent treatment strategy
evaluations will still be covered by CMS only if patients are enrolled in an
approved clinical trial or registry. The NOPR has sought and obtained CMS
approval to continue its data collection to allow for coverage of PET scans
performed for these cancers and indications.
How to Register as a Participating Site
Any PET facility that is approved to bill CMS for either technical or global
charges can apply to participate in the NOPR. Sites are not required to have ACR
or ICANL accreditation to participate. PET facilities interested in
participating in the NOPR will complete the Facility
Registration Form
and submit it to NOPR Headquarters together with an executed HIPAA
Business Associates Agreement (BAA). NOPR will
assign a facility ID number and send an invoice for the facility registration
fee ($50) and the escrow account (amount determined by the facility).
Patient Eligibility
Medicare beneficiaries (with Medicare as their primary insurance) who are
referred for PET for those oncologic indications that are not currently
reimbursable under Medicare are eligible to participate in the NOPR. The
Indications table
lists the cancers and indications that are accepted in the Registry.
PET Facility Responsibilities
The PET facility is responsible for collecting and entering patient data into
the Registry database through a web application at www.CancerPETregistry.org.
Below is a brief summary of the data collection procedure.
- When a patient eligible for entry into the NOPR presents at the PET facility, the facility contacts the referring physician and obtains confirmation that the referring physician will submit the pre- and post-PET data requirements.
- The PET facility registers the patient on the NOPR via a Web form, at which time a Registry case number is assigned.
- The NOPR will send confirmation to the PET facility and e-mail a copy of the
pre-PET data form to the PET facility administrator if it is indicated on the
case registration form that the pre-PET form has not already been completed by
the referring physician.
- The referring physician must complete and return the Pre-PET Form
to the PET facility for entry into the NOPR database by midnight of the day of
the PET scan.
- After the PET scan is performed, the PET facility must submit the PET
completion form within 14 days of the case registration date.
- After the interpreting physician reads the report, the PET facility sends the
PET report to the referring physician, and submits the report electronically to
the NOPR database.
- The database will send the PET facility administrator a patient-specific
Post-PET Form after
the PET report has been submitted. This form must be completed, returned to the
PET facility, and entered into the NOPR database within 30 days of the PET scan.
Referring Physician's Responsibilities
The patient's referring physician must agree to complete pre- and post-PET data collection forms consisting of a few questions regarding the patient's planned management.
- The Pre-PET Form must be completed 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 will be e-mailed to the PET facility for delivery to the referring physician. The Pre-PET Form can be returned to the PET facility via, FAX, mail, or hand delivery.
- After the PET is performed a patient-specific Post-PET Form will be 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.
How to Obtain Medicare Reimbursement
The NOPR database will notify the PET facility when all case data have been entered. The PET facility can then bill CMS for the study. The PET facility can check on the case status of their patients at any time via the reporting tools available on the NOPR Web site.
Sponsored by:
- Academy of Molecular Imaging
Endorsed by:
- American College of Radiology
- American Society of Clinical Oncology
- Society for Nuclear Medicine
Managed by:
- American College of Radiology
- American College of Radiology Imaging Network
Advisor:
- Centers for Medicare & Medicaid Services
NOPR Working Group
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