TABLE 1

Medicare-Approved Indications for PET in Oncology

Tumor typeInitial treatment strategySubsequent treatment strategy
ColorectalCoveredCovered
EsophagusCoveredCovered
Head and neck (not thyroid or central nervous system)CoveredCovered
LymphomaCoveredCovered
Non–small cell lungCoveredCovered
OvaryCoveredCovered
BrainCoveredCED
CervixCovered with exception*Covered
Small cell lungCoveredCED
Soft-tissue sarcomaCoveredCED
PancreasCoveredCED
TestisCoveredCED
Breast (female and male)Covered with exceptionCovered
MelanomaCovered with exceptionCovered
ProstateNot coveredCED
ThyroidCoveredCovered with exception or CED§
All other solid tumorsCoveredCED
MyelomaCoveredCovered
All other cancers not listedCEDCED
  • * Cervical cancer nationally not covered for initial diagnosis.

  • Breast cancer nationally not covered for initial diagnosis or staging of axillary lymph nodes.

  • Melanoma nationally not covered for initial staging of regional lymph nodes.

  • § Thyroid cancer nationally covered for subsequent treatment strategy for recurrent or residual thyroid cancer of follicular cell origin, previously treated by thyroidectomy and radioiodine ablation, with serum thyroglobulin level of greater than 10 ng/mL, and negative 131I whole-body scan results.

  • CED = coverage with evidence development.

  • (Adapted from (55).)