On February 10, the Centers for Medicare & Medicaid Services (CMS) announced a national coverage determination that expands coverage for lung cancer screening with low-dose computed tomography (CT) to improve health outcomes for people with lung cancer. This type of screening is aimed at early detection of non–small cell lung cancer.
This final decision expands eligibility for people with Medicare to get lung cancer screening with low-dose CT by lowering the starting age for screening from 55 to 50 years, and reducing the tobacco smoking history from at least 30 pack-years to at least 20 pack-years (calculated as the number of packs smoked per day multiplied by the number of years the person has smoked). The only recommended screening test for lung cancer is low-dose CT.
“Expanding coverage broadens access for lung cancer screening to at-risk populations,” said CMS Chief Medical Officer and Director of the Center for Clinical Standards and Quality Lee A. Fleisher, MD. “[This] decision not only expands access to quality care but is also critical to improving health outcomes for people by helping to detect lung cancer earlier.”
The final decision also simplifies requirements for the counseling and shared decision-making visit and, based on public comments received on the proposed national coverage determination and additional review, removes the requirement for the reading radiologist to document participation in continuing medical education, thereby reducing administrative burden on providers. CMS also added a requirement back to the national coverage determination criteria for radiology imaging facilities to use a standardized lung nodule identification, classification, and reporting system.