National Oncologic PET Registry (NOPR)

What is the National Oncologic PET Registry?

The purpose of the National Oncologic PET Registry (NOPR) is to prospectively examine how the use of PET impacts the management of patients with suspected or known cancer. The information gathered by the NOPR will help identify the most effective applications of PET in oncology patients. This information will be used by the Centers for Medicare and Medicaid Services (CMS) and other health insurance providers to decide whether to pay for PET scans for a wider range of cancer types or cancer-related indications in the future.

Currently, CMS is providing coverage for PET scans performed for non-covered cancer types and indications under a new program known as “coverage with evidence development (CED).” Both the referring physician’s and the patient’s participation in the research program is voluntary. If either individual refuses to participate in the research program, the patient’s data and PET information will not be used for research purposes. The ability to request future PET scans will not be affected. However, completion of the pre– and post– PET forms, within 30 days after the PET scan, is a requirement for CMS reimbursement.

All data will be sent to CMS, but the dataset used by NOPR investigators for research will contain only the data of those patients and physicians who consent to have the data included.


Indications

 
Lip, Oral Cavity, Pharynx
C
C
C
X
Stomach, Small Intestine, Anus
X
X
X
X
Esophagus, Colon & Rectum
C
C
C
X
Liver & Intrahepatic Bile Ducts
X
X
X
X
Gallbladder & Extrahepatic Bile Ducts
X
X
X
X
Pancreas, Retroperitoneum & Peritoneum
X
X
X
X
Nasal Cavity, Ear & Sinuses, Larynx
C
C
C
X
Lung, non-small cell
C
C
C
X
Lung, small cell
X
X
X
X
Pleura, Thymus, Heart, Mediastinum
X
X
X
X
Bone/Cartilage, Connective/Other Soft Tissue
X
X
X
X
Melanoma of Skin
C
C1
C
X
Female Breast
NC
C1
C
C
Male Breast
X
X
X
X
Kaposi’s Sarcoma
X
X
X
X
Uterus, Ovary & Uterine Adnexa
X
X
X
X
Cervix
X
C
X
X
Prostate, Testis, Penis & Other Male Genitalia
X
X
X
X
Bladder, Kidney & Other Urinary Tract
X
X
X
X
Eye
X
X
X
X
Primary Brain
X
X
X
X
Thyroid
X
X
C
X
Lymphoma
C
C
C
X
Myeloma
X
X
X
X
Lukemia
X
X
X
X
Solitary Pulmonary Nodule
C
NA
NA
NA
Other or Not Listed
X
X
X
X
  • X = Eligible for Entry in NOPR
  • C = Nationally Covered Indication (Not Eligible for NOPR)
  • NC = Not Eligible for Entry In NOPR (Nationally non-covered Indication)
  • NA = Not Applicable
  • C1 = Does not cover initial staging for axillary lymph nodes for breast cancer patients and regional lymph nodes for melanoma patients.

Which patients are eligible for the NOPR?

Medicare beneficiaries, or patients who are enrolled in a managed Medicare health plan, who are referred for PET for essentially all oncologic indications that are not currently reimbursable under Medicare (see chart) are eligible to participate in the NOPR. Patients with insurance coverage other than Medicare, including Medicaid are not eligible.

What are the referring physician’s responsibilities?

The patient’s referring physician must agree to complete pre– and post-PET scan data collection forms consisting of approximately 5 multiple choice questions regarding the patient’s diagnosis and planned management.

The forms can be completed by the referring physician’s ancillary personnel; however, the NOPR asks that the referring physician review the forms for accuracy.

The questionnaires should take no longer than 3 minutes to complete and can be sent to you via fax or email. They can also be found on our website at www.mdrny.com or the NOPR website at www.cancerpetregistry.org.

The patient’s PET study is eligible for CMS reimbursement only if the pre-PET form is completed and returned to us prior to the PET scan, and the post-PET form is completed and returned within 30 days of the PET scan.

If you have any further questions regarding Positron Emission Tomography please contact MDR or Craig Sherman, MD directly.