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.


Shrewsbury Diagnostic Imaging has on-site board certified Radiologists.

Shrewsbury Diagnostic Imaging
1131 Broad Street (HWY 35)
Suite 110
Shrewsbury, NJ 07702
Phone - 732-578-9640
Fax - 732-578-9650
Map & Directions

Our Staff:
Mary Constantino, Administrator
Marguerite Simeone, Marketing Representative
Cell Phone - 732-284-0992
Matthew Campbell, CNMT

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