Expanded Coverage for Lung Cancer Screening

As you may have heard, the Centers for Medicare and Medicaid Services (CMS) recently announced a national coverage determination that expands coverage for lung cancer screening with low dose computed tomography (LDCT).

 

The final decision, which came in to effect in early February, expands eligibility for people with Medicare to get lung cancer screening with LDCT by lowering the starting age for screening from 55 to 50 years and reducing the tobacco smoking history from at least 30 packs per year to at least 20 packs per year. The only recommended test for lung cancer is LDCT.

 

Before the patient's first lung cancer LDCT screening, they must receive a counselling and shared decision-making visit that meets all the follow criteria:

 

• Determination of beneficiary eligibility

• Shared decision-making, including the use of one or more decision aids

• Counseling on the importance of adherence to annual lung cancer LDCT screening, impact of comorbidities and ability or willingness to undergo diagnosis and treatment 

• Counseling on the importance of maintaining cigarette smoking abstinence if former smoker; or the importance of smoking cessation if current smoker and, if appropriate, furnishing of information about tobacco cessation

 

Patient eligibility criteria:

• Age 50 – 77 years*

• Asymptomatic (no signs or symptoms of lung cancer)

• Tobacco smoking history of at least 20 pack-years 

• Current smoker or one who has quit smoking within the last 15 years

• Receives a written order for LDCT lung cancer screening that meets certain criteria