Humana will now cover PET/CT for cardiac/neurologic indications and SPECT/CT for others, according to the Society of Nuclear Medicine and Molecular Imaging (SNMMI).
After months of lobbying by the SNMMI, the new coverage policy reflects scientific evidence and is in line with the Centers for Medicare and Medicaid Services' (CMS) decision on the use of F-18 FDG-PET for infection and inflammation.
Humana's policy is currently in draft form but says Humana members may be eligible for PET/CT for myocardial viability assessment, suspected prosthetic valve endocarditis, and sarcoidosis with suspected cardiac involvement given certain conditions. Also, members may receive SPECT/CT for preoperative localization of parathyroid adenomas and for presurgical evaluation to localize the focus of refractory seizure activity.
SNMMI has been advocating for coverage of suspected prosthetic valve endocarditis for the past five years.
