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NaF-18 PET for Bone Metastasis

This national coverage determination (NCD) was issued on February 26, 2010.  It establishes specific clinical indications under which CMS will cover NaF-18 Positron Emission Tomography (NaF-18 PET).  The NCD concluded that NaF-18 PET scans are reasonable and necessary under Section 1862(a)(1)(E) of the Social Security Act in the context of Coverage with Evidence Development (CED).

Prospectively under CED, NaF-18 PET imaging must lead to:

  • A change in patient management to more appropriate palliative care; or
  • A change in patient management to more appropriate curative care, or
  • Improved quality of life; or
  • Improved survival

The clinical research study also must adhere to certain standards of scientific integrity and relevance to the Medicare population.


Decision memorandum:


On its website, CMS will maintain a list of all approved studies and facility locations.  There are approximately 2200 facilities participating in the clinical research study for NaF-18 PET.  A list of facility locations can be found here:


The following study has been approved by CMS: The National Oncologic PET Registry (NOPR)


Information on the clinical study may be found at:

The protocol for FDG PET for Solid Tumors was amended to include a second clinical research study to include this NCD.