# Medicare NCD 220.6.19: NaF-18 PET for bone metastases

Source: https://onco.cc/terms/medicare-ncd-220-6-19/  
OnCo record `medicare-ncd-220-6-19` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Medicare no longer pays nationally for sodium fluoride (NaF-18) PET scans to look for cancer in the bones; local contractors may cover other PET tracers used as their FDA labels allow.

## Summary

United States, Medicare National Coverage Determination 220.6.19, version 2 (listed effective date 15 December 2021, implemented 17 January 2022). The text explains that "the confirmatory analyses were not published during the 24-month time period", so "effective December 15, 2017, CMS determines that there are no nationally covered indications for PET NaF-18" and that NaF-18 PET is nationally non-covered. Other PET radiopharmaceuticals for cancer can be covered at local contractors' discretion when used according to their FDA-approved indications. The NCD says it was last reviewed in December 2017.

## Fields

- Kind: Term
- Last checked: 2026-11-04
- Also known as: NCD 220.6.19; Positron Emission Tomography (NaF-18) to Identify Bone Metastasis of Cancer; Medicare sodium fluoride PET coverage
- Tags: us

## Notes

- The NCD's effective-date field reads 15 December 2021 while its text dates the non-coverage decision to 15 December 2017; both are stated as the API returned them.
- The 24-month period refers to the earlier coverage with evidence development arrangement under which NaF-18 PET was paid for; the text read does not restate its terms.

## Sources

- CMS Medicare Coverage Database: the NCD: https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=336&ncdver=2
- CMS Coverage API: the NCD text as data: https://api.coverage.cms.gov/v1/data/ncd?ncdid=336&ncdver=2

## Connected records

- terms: [Bone metastases and skeletal-related events](https://onco.cc/terms/bone-metastases/), [Medicare coverage with evidence development](https://onco.cc/terms/medicare-ced/), [Medicare NCD 220.6.17: FDG PET for cancer](https://onco.cc/terms/medicare-ncd-220-6-17/)
- technologies: [PET/CT](https://onco.cc/technologies/pet-ct/)
- institutions: [Centers for Medicare & Medicaid Services (CMS)](https://onco.cc/institutions/cms/)

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JSON: https://onco.cc/api/v1/entities/medicare-ncd-220-6-19.json