The Centers for Medicare and Medicaid Services (CMS) has expanded parameters for coverage of lung cancer screening with low-dose computed tomography (LDCT), in an effort to cover more individuals and facilitate the diagnosis of lung cancer at earlier, more treatable stages.

Under the new parameters, screening age eligibility for individuals covered by Medicare has been lowered from 55 to 50 years. Parameters for tobacco smoking history have also been reduced from at least 30 packs per year to at least 20 packs per year. The parameters apply to asymptomatic individuals who are current smokers or have quit smoking within the last 15 years.

Prior to recommendation for screening, a candidate must have a shared decision-making visit that meets the following criteria:

  • Eligibility determination;
  • Shared decision-making;
  • Counseling on the importance of annual LDCT screening adherence, comorbidities, and ability or willingness to undergo diagnosis and treatment; and
  • Counseling on the importance of cigarette abstinence (former smokers) or cessation (current smokers), with cessation information provided when appropriate.

“Expanding coverage broadens access for lung cancer screening to at-risk populations,” Lee A. Fleisher, M.D., chief medical officer of CMS and director of the Center for Clinical Standards and Quality, said in a press release. “Today’s decision not only expands access to quality care but is also critical at improving health outcomes for people by helping detect lung cancer earlier.”

Sources:

https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?proposed=N&ncaid=304

https://www.cms.gov/newsroom/press-releases/cms-expands-coverage-lung-cancer-screening-low-dose-computed-tomography