World of PET/About Your PET Scan



		Before Scan \| Scan Length \| Procedure \| How will I feel \| About \| Scheduling Scan \| Insurance Your Physician has ordered a Positron Emission Tomography (PET) scan for you. PET images can provide important information about many conditions affecting the heart, brain, and other organs, which will help your doctor plan appropriate treatment for you. PET images are different than those from more conventional imaging equipment, such as x-ray, CT, Ultrasound, or MRI. These images show what the tissues look like. PET images contain information about tissue function.

		This will depend on the type of study, but typically, you will be asked not to eat or drink anything after midnight the night before your scan.

		You can expect to be in the PET center for one and a half to three hours. The actual scan itself takes far less time.

		To begin the procedure, a small amount of radioactive glucose (or similar tracer) is injected into your bloodstream. There is no danger to you from this injection. Glucose (also known as sugar) is a common substance every cell in your body needs in order to function. Radioactive glucose must pass multiple quality control measures before it is used for any patient injection. The radiation exposure associated with PET is similar to that associated with a conventional CT scan. After the injection, you will wait approximately an hour, while the injection material is distributed throughout your body. Then, you will be asked to lie on a table that passes slowly through the scanner. The scanner resembles a CT scanner, but has a much larger opening. Some people fall asleep during the scan.

		You should feel fine. There are no side-effects from the injected tracer. If you have a heart scan, you may feel flushed afterward.

		Safe. Can be performed in about 2 hours as an outpatient procedure.

		Whole body PET scans can be ordered by any physician involved in your care. The studies are read shortly after the PET scan is completed and patients can expect verbal reports to be available to their physicians on the day of the study.

		Most insurance companies pay for clinically indicated PET procedures. To be clinically indicated, the PET scan must be potentially beneficial in providing information supportive of a diagnosis or monitoring certain conditions. Many insurance companies have coverage policies for certain clinical situations where PET scans have been proven to be useful. Since PET is a growing field, the data sometimes lags behind coverage policies. Therefore, the indication may be covered, even though it may not be on the standard coverage list. This does not mean that the insurance company will not pay for a clinically indicated PET scan. It is important to contact your insurance company to determine if the PET scan is covered. Most insurance companies require pre-authorization for a PET scan. Physicians routinely provide clinical information to the insurance company to obtain the pre-authorization. Many coverage policies are local, so it is important to determine the coverage policies from the major payers in your area. Medicare PET scans have been approved for reimbursement under Medicare for the following: Source: Section 50-36 of the CMS Coverage Manual and CMS Decision Memoranda #CAG-00094A and #CAG-00098N Private Insurance - Reimbursement for PET scan indications Most private insurance companies cover the same indications as Medicare covers. Private insurance companies may cover additional indications. In either case, it is prudent to check with your insurance company prior to having a PET scan. The cost for the PET scan has three components: (1) the FDG radiopharmaceutical, (2) the actual scan, and (3) the professional physician who reads/interprets the scan. Self-Payment Plan If your private insurance does not cover PET and you are not a candidate for Medicare, you may want to self-fund your PET scan. Please call us for information about payment arrangements.

Medicare

Private Insurance - Reimbursement for PET scan indications

Self-Payment Plan