Friday, November 5, 2021

Lung Cancer Screening NCD Under Review: Proposal Expected November 18, 2021

Takeaway:  CMS is reviewing its 2015 NCD for low dose CT lung cancer screening, and will issue a draft revised NCD by November 18, 2021.


I believe I missed this first time around.  CMS created a national Medicare benefit for low-dose CT lung cancer screening in February 2015 (here).  At the time, CMS seemed to view the issue as relatively delicate, because RCTs had found a clinical benefit for LDCT screening, but the rate of discovering worrisome nodules, repeat CT testing, or having biopsy adventures was high.   

Another issue is that USPSTF, though operating slowly, can issue revisions to its endorsements at least year or two faster than CMS can update its NCDs, following such a USPSTF revision.

So, long story short, in May 2021, CMS opened an NCD review of its 2015 LDCT NCD.   The draft NCD revision should appear by November 18, 2021.  The reopening was based on a written 17-page request, filed on March 9 by GO2 Foundation, STS, and ACR.    The public stakeholders ask CMS to update the NCD to match the most recent USPSTF position, and make some other changes to details of the NCD.