Does the capped OPPS rate for the TC component for PET include the FDG charge?
A. No, the capped payment rates do not include reimbursement for the FDG. Q. What is the actual reimbursement from Medicare for a PET/CT whole-body scan. I had heard PET/CT was not on the Medicare list for cuts as of 12/25/2006. A. In Florida, the various Medicare Part B carriers have posted on their websites the 2007 payment cap for imaging services fee schedules. For some reason the capped fee schedule posted on the Florida Medicare Part B website does not list the PET codes. All other Medicare Part B carrier websites I have looked at do list the PET codes in their payment cap fee schedules except for Florida Medicare. I cannot explain this discrepancy. As a reference, Trailblazer Health, the Medicare Part B carrier for MD, VA, TX, DE, and D.C., has a master list of the capped fee schedules for all states posted on their website. The list of capped fee schedules is alphabetical by state. The capped fee schedule for Florida does list the capped payment amounts for the PET codes for th
