Lung Cancer Screening

In December 2013, the U.S. Preventive Services Task Force (USPSTF) grade "B" recommendation for CT screening for high-risk individuals was made final. The USPSTF defines as high-risk factors as:

• People ages 55-80
• Those with ≥ 30 pack-year smoking history
• Current or former smokers who have quit within the past 15 years.

On February 5, 2015, the Centers for Medicare & Medicaid Services (CMS) issued a final national coverage determination (NCD) that provides for Medicare coverage of screening lung cancer with low dose computed tomography (LDCT). The coverage became effective immediately.

Medicare now covers lung cancer screening with LDCT once per year for Medicare beneficiaries who meet all of the following criteria:

• they are age 55-77, and are either current smokers or have quit smoking within the last 15 years;
• they have a tobacco smoking history of at least 30“pack years”(an average of one pack a day for 30 years); and
• they receive a written order from a physician or qualified non-physician practitioner that meets certain requirements.

Medicare coverage includes a visit for counseling and shared decision-making on the benefits and risks of lung cancer screening. The NCD also includes required data collection and specific coverage eligibility criteria for radiologists and radiology imaging centers, consistent with the National Lung Screening Trial protocol, U.S. Preventive Services Task Force recommendation, and multi-society multidisciplinary stakeholder evidence-based guidelines.

Access the CMS Lung Cancer Decision Memo