National Coverage Analysis (NCA) Tracking Sheet

Beta Amyloid Positron Emission Tomography in Dementia and Neurodegenerative Disease



PET is a minimally-invasive diagnostic imaging procedure used to evaluate normal tissue as well as in diseased tissues in conditions such as cancer, ischemic heart disease, and some neurologic disorders. An injected radioactive tracer gives off subatomic particles, known as positrons, as they decay. PET uses a positron camera (tomograph) to measure the decay of these radioisotopes. The rate of tracer decay provides biochemical information on the tissue being studied. Certain tracers allow for imaging of beta-amyloid plaques in the brain of patients with cognitive impairment who are being evaluated for possible Alzheimer's disease or other causes cognitive decline.

Section 220.6 of the National Coverage Determination Manual identifies ammonia N-13, fluorodeoxyglucose F-18, rubidium Rb-82 and sodium fluoride F-18 as the only nationally covered radioisotopes for certain defined uses in PET. Certain uses of PET with these radioisotopes are covered only when performed under Coverage with Evidence Development (CED) in clinical studies. All remaining uses of PET are nationally noncovered.

CMS is reconsidering Section 220.6 of the National Coverage Determination (NCD) Manual pursuant to a request from the Eli Lilly and Company that coverage for PET tracers be expanded to include those agents that image beta-amyloid plaques in the context of the diagnosis of dementia.

CMS is soliciting public comment relevant to this request. We are particularly interested in comments that include scientific evidence.

Benefit Category

Diagnostic Tests (other)

Requestor Information

Requestor Name Requestor Letter
Eli Lilly and Company View Letter

Important Dates

Formal Request Accepted and Review Initiated
Expected NCA Completion Date
Public Comment Period
10/09/2012 - 11/08/2012
Proposed Decision Memo Due Date
Proposed Decision Memo Released
Proposed Decision Memo Public Comment Period
07/03/2013 - 08/02/2013
Decision Memo Released
Comments for this NCA
View Public Comments


Lead Analysts
Brijet Burton Coachman, MPP, MS, PA-C
Stuart Caplan, RN, MAS
Lead Medical Officers
Joseph Hutter, MD, MA

Medicare Benefit Category Determination Date

Actions Taken

October 9, 2012

CMS opens this reconsideration of Section 220.6 of the NCD on Positron Emission Tomography as it relates to beta-amyloid imaging in the context of the diagnosis of dementia. The initial 30-day public comment period begins with this posting date, and ends after 30 calendar days. CMS considers all public comments, and is particularly interested in clinical studies and other scientific information relevant to the topic under review.

Instructions on submitting comments can be found at:

To submit a comment, please use the orange "Comment" button at the top of the page. Enter comments directly into the "Submit A Public Comment" webpage.

July 3, 2013

September 27, 2013