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Medicare in the United States pays for a yearly low-dose CT scan of the chest for people aged 50 to 77 with no symptoms who have smoked at least 20 pack-years and still smoke or quit within the last 15 years. A conversation about the benefits and harms comes first, and the patient pays no coinsurance or deductible.
United States, Medicare National Coverage Determination 210.14 (NCD Manual, publication 100-3), version 2, effective for claims with dates of service on or after 10 February 2022, implemented 3 October 2022. CMS covers it as an "additional preventive service" under section 1861(ddd) of the Social Security Act, which requires a United States Preventive Services Task Force grade of A or B.
Eligibility, in the NCD's words: "Age 50 - 77 years"; "Asymptomatic (no signs or symptoms of lung cancer)"; "Tobacco smoking history of at least 20 pack-years (one pack-year = smoking one pack per day for one year; 1 pack =20 cigarettes)"; "Current smoker or one who has quit smoking within the last 15 years"; and an order for screening. Before the first scan the beneficiary must have a counselling and shared decision-making visit that uses one or more decision aids, covers the importance of yearly adherence, comorbidities and willingness to be treated, and covers smoking cessation or continued abstinence. The reading radiologist must be board certified or board eligible with the American Board of Radiology or an equivalent body, and the facility must use "a standardized lung nodule identification, classification, and reporting system". Part B coinsurance and deductible are waived. The NCD says it was last reviewed in February 2022.
Showing the technology this term belongs to: Low-dose CT lung screening.
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