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Physician Home | Insurance Coverage Insurance Coverage
Most insurance companies pay for clinically indicated PET and PET/CT procedures. To be clinically indicated, the procedure must be potentially beneficial in providing information supportive of a diagnosis or monitoring certain conditions.
Private Insurance Generally, most private insurance companies cover the same indications as Medicare, although some may cover more indications and some may cover fewer indications. Private payers can have wide variations in coverage policies, coverage criteria or procedures. The referring physician and the imaging center work together to verify specific local coverage guidelines and to obtain pre-authorization prior to performing the scan. Medicare The Centers for Medicare and Medicaid Services (CMS) coverage policies for PET and PET/CT indications are decided at a national level and are documented in a National Coverage Determination (NCD), section 220.6 Medicare Covered Indications. National Oncologic PET Registry (NOPR) The National Oncologic PET Registry (NOPR) was developed in response to the Centers for Medicare and Medicaid Services (CMS) proposal to expand coverage for FDG PET to include cancers and indications not presently eligible for Medicare reimbursement. Medicare reimbursement for these cancers is available if the patient's referring physician and the imaging provider submit data to a clinical registry to assess the impact of PET on cancer patient management. The NOPR implements this registry for CMS. Please contact our office with questions regarding insurance and coverage for PET scans. Our mission is to provide excellent outpatient diagnostic imaging service to each patient in a family-oriented and professional environment that exceeds the expectations of those we serve. We are committed to collaborate with our community to improve the health status of patients and raise diagnostic confidence. Doral Imaging Institute Corporate Park of Doral 7775 N.W. 48th Street Suite 150 Doral, FL. 33166 Phone: 305.594.2881 Fax: 305.594.2871 Hours of Operation: 7 a.m - 6 p.m. Monday thru Friday 8 a.m - 2 p.m. Saturday (To better meet the needs of our patients, same day appointments and extended evening hours available) Our Staff: Gabriel A. Arcila, M.D., A.B.N.M., A.B.R. Medical Director Alberto Gil de Montes, BS, MS, CNMT Natasha Tonti, Patient Care Coordinator Melissa Piņero, Director of Public Relations & Int'l Business Email Us |