# Medicare NCD 220.6.17: FDG PET for cancer

Source: https://onco.cc/terms/medicare-ncd-220-6-17/  
OnCo record `medicare-ncd-220-6-17` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Medicare pays for one FDG PET scan to plan the first treatment of most cancers, and for three more scans after the first treatment is finished; a local contractor decides on any further scans. A few uses are excluded, such as planning first treatment for prostate cancer.

## Summary

United States, Medicare National Coverage Determination 220.6.17, version 4, effective for claims with dates of service on and after 11 June 2013, implemented 7 March 2014. At the request of the National Oncologic PET Registry, CMS ended the prospective data collection that coverage with evidence development (CED) had required for every oncologic use of FDG PET. The decision does not change coverage of PET with NaF-18, ammonia N-13 or rubidium-82.

Initial anti-tumour treatment strategy: CMS covers "one FDG PET study for beneficiaries who have cancers that are biopsy proven or strongly suspected" when the treating physician needs it to decide whether an invasive procedure is appropriate, where to do it, or the anatomic extent of the tumour. Subsequent strategy: "Three FDG PET scans are nationally covered when used to guide subsequent management of anti-tumor treatment strategy after completion of initial anti-cancer therapy"; coverage of more than three is left to the local Medicare Administrative Contractors.

The NCD's synopsis table covers both stages for colorectal, oesophageal, head and neck (not thyroid or CNS), lymphoma, non-small cell and small cell lung, ovary, brain, soft tissue sarcoma, pancreas, testes, thyroid, myeloma, all other solid tumours and all other cancers. The exceptions for initial strategy: prostate adenocarcinoma is non-covered; breast is non-covered for diagnosis and initial staging of axillary nodes but covered for staging distant metastasis; melanoma is non-covered for evaluating regional lymph nodes; cervix is non-covered for initial diagnosis but covered for staging newly diagnosed cancer after conventional imaging. Every cancer in the table, including prostate, is covered for subsequent strategy.

## Fields

- Kind: Term
- Last checked: 2026-11-04
- Also known as: NCD 220.6.17; Positron Emission Tomography (FDG) for Oncologic Conditions; Medicare FDG PET coverage
- Tags: us

## Notes

- Earlier FDG PET coverage required enrolment in the National Oncologic PET Registry under CED; this NCD is the 2013 decision that ended that requirement for cancer.

## Sources

- CMS Medicare Coverage Database: the NCD: https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=331&ncdver=4
- CMS Coverage API: the NCD text as data: https://api.coverage.cms.gov/v1/data/ncd?ncdid=331&ncdver=4

## Connected records

- cancers: [Breast cancer (all types)](https://onco.cc/cancers/breast-cancer/), [Cervical cancer](https://onco.cc/cancers/cervical/), [Colorectal cancer](https://onco.cc/cancers/colorectal/), [Melanoma](https://onco.cc/cancers/melanoma/), [Multiple myeloma](https://onco.cc/cancers/multiple-myeloma/), [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/), [Ovarian cancer](https://onco.cc/cancers/ovarian/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/), [Prostate cancer](https://onco.cc/cancers/prostate/), [Small-cell lung cancer](https://onco.cc/cancers/sclc/)
- technologies: [FDG PET](https://onco.cc/technologies/fdg-pet/), [PET/CT](https://onco.cc/technologies/pet-ct/)
- institutions: [Centers for Medicare & Medicaid Services (CMS)](https://onco.cc/institutions/cms/)
- terms: [Medicare coverage with evidence development](https://onco.cc/terms/medicare-ced/), [Medicare NCD 220.6.19: NaF-18 PET for bone metastases](https://onco.cc/terms/medicare-ncd-220-6-19/)

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