More Medicare beneficiaries now meet age, smoking history, and other criteria for lung cancer screening and are now eligible to receive low-dose computed tomography (LDCT), according to a February 2022 memo from the Centers for Medicare and Medicaid Services (CMS).
CMS said it reconsidered the national coverage determination and found sufficient evidence to support expansion of eligibility criteria for Medicare beneficiaries to receive LDCT, a recommended screening test for individuals who have a high risk of developing lung cancer based on their age and smoking history.
The revised beneficiary eligibility criteria are:
- Aged 50–70 years
- No signs or symptoms of lung cancer
- Tobacco smoking history of at least 20 pack-years
- Current smoker or one who has quit smoking in the past 15 years
- Receive an order for lung cancer screening with LDCT
CMS also said that to qualify, the beneficiary must receive counseling and a shared decision-making visit to discuss beneficiary eligibility, adherence to annual LDCT screening and impact of comorbidities, and maintaining cigarette smoking abstinence and smoking cessation. Screening must also be furnished in a radiology imaging facility that uses a standardized lung nodule identification, classification, and reporting system.
“The policy simplifies requirements for the counseling and shared decision-making visit, removes the restriction that it must be furnished by a physician or non-physician practitioner, reduces the eligibility criteria for the reading radiologist, and reduces the radiology imaging facility eligibility criteria,” CMS said.