Sodium Flouride PET/CT Scan Cost

[kick-prostate-cancer]

My husband is coming up on his last two rounds of Docetaxel, and then it's time for his follow-up scan to see how well the chemo worked. Well, called to make the appointment, and I was told that Medicare no longer pays for that particular scan. His MO feels it's very important to compare apples-to-apples before and after. The scan is over $8,000. YIKES! I plan on negotiating with the hospital. Wanted to know if any of you have negotiated for this scan, and if so, what price did you end up paying?

Thanking you in advance!!

[Tall_Allen]

I think Medicare will approve it if the facility is keeping a registry. You'd have to call around to find one -- or maybe CMS can tell you.

[kick-prostate-cancer in reply to Tall_Allen]

CMS?

[Tall_Allen in reply to kick-prostate-cancer]

Centers for Medicare and Medicaid Services

[kick-prostate-cancer in reply to Tall_Allen]

Thanks

[Tall_Allen in reply to kick-prostate-cancer]

cms.gov/medicare/medicare-g...

[kick-prostate-cancer]

We have Blue Shield of CA ... more than a supplemental Medicare policy. However, if they only pay what Medicare doesn't cover ONCE Medicare has paid their share. So much stress!!!

[Startanew]

Try contacting the American Cancer society to see if they will fund it

[kick-prostate-cancer in reply to Startanew]

Thanks

[ctarleton]

On the other hand....

Since June 2018, imaging professionals don't like that "CMS Refuses Medicare Coverage of NaF PET Scans":

acr.org/Advocacy-and-Econom...

healthimaging.com/topics/mo...

despite having had a couple of years to try to gather more data and to convince them, per the original Decision Memo:

cms.gov/medicare-coverage-d...

[Tall_Allen in reply to ctarleton]

So they won't even cover it anymore if it is part of a clinical trial or registry?

Kick - If you can't get it elsewhere, NIH is running a clinical trial where you can get it (and DCFPyL) for free. Call Yolanda:

clinicaltrials.gov/ct2/show...

[SeosamhM in reply to ctarleton]

Right, Ctar....this decision affected me even with my private insurance - they refused to pay for it. So, to get that "apples to apples" comparison, I ended up paying for it out of pocket. But it was 5K cheaper than Kick was quoted for her husband....

[tango65]

In the west coast UCLA does the Ga 68 PSMA PET/CT for $ 2750.

310-794 1005

[curt504]

Commercial imaging centers have sprung up in most cities. Call and ask "what is your cash walk in price for ...". Our broken health care system has hospitals where all tests are always astronomically priced, you are funding the lobby art, presidents salaries on down. The specialized imaging centers have low over head and might do that scan for $2k or less. In Atlanta a prostrate mp MRI 3 tesla often a $5k on down test can be had for $800 if you press them for the "lowest cash price"...

[EdBar]

Why not get an Axumin scan? It is covered by Medicare and superior to a Sodium Flouride scan?

[Hidden]

Ask your guy if he can compare with a T99 scan? Yes, the new fangeled Pst Scan is more accurate, but the old T99 is what has been used for years. Since 2003, I have had two dozen of them them; the last in 2016.

GD

[monte1111]

The medical field. Only field on earth where cash is not king. Insurance companies never pay cash prices. I believe at one time medical bills were biggest reason for bankruptcies. And the majority of those people had medical insurance. There is absolutely no transparency. The corruption begins with educational system (student debt about to cause another revolt/monetary crisis?); through insurance companies, politicians, medical establishments, to your local doctor. But this isn't a political site. Sorry for the rant.

[j-o-h-n in reply to monte1111]

Rant all you want.... we ignore you anyway 🈶🈶🈶

Remember, Confucius say "Money Talks, Bullshit Walks".

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 02/21/2019 7:42 PM EST

[monte1111 in reply to j-o-h-n]

That's a good image. Walking bullshit. As a youngster I stepped in my share of cow pies. Covered your whole shoe and half way up your knee socks. I was indeed, Walking Bullshit.

[j-o-h-n in reply to monte1111]

What a sight...

That's supposed to mean good luck...Yuckie Pooh... Well when I grew up in the south Bronx I would step in dog doo doo in the streets (sidewalks). They've passed laws (thank goodness) to clean up after your dog using pooper scoopers.

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 02/21/2019 9:34 PM EST

[Sxrxrnr1 in reply to j-o-h-n]

Some of these scoopers might be a great idea for SFO,,,,but not for dogs, if’n you know what I mean.

[j-o-h-n in reply to Sxrxrnr1]

I sure doo.... Great city Crazy politics... The inmates are running the asylum.

By George, it's his birthday.

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 02/22/2019 5:23 PM EST

[Sxrxrnr1 in reply to j-o-h-n]

My office was right in the middle of downtown financial area throughout the 80’s and 90’s. At one time a number one lovely city,,,,now some would suggest would make Charlton Heston’s city(New York I believe) in Soylent Green appear as Paris.

Fortunately now, sad but true only visit when going to UCSF, thankfully not close to downtown.

[j-o-h-n in reply to Sxrxrnr1]

I'm looking to relocate there but preferably in Sausalito with a view of the city. Real Estate taxes are triple what I pay in New York City. So it looks like I'm going to stay here with the snow. What originally sold me on Sausalito is years ago I had a meeting with Issacs of "Fair Issacs" the Fico credit score people who were located in Sausalito. Too bad Sf is so fxxked up.

By George, it's his birthday.

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 02/22/2019 8:10 PM EST

[Sxrxrnr1]

I had mentioned some weeks or months ago(time flies) in a posting on this forum that Medicare no longer paid for NAF. I found this out over a year ago some 30 minutes before I was set to receive one, was told by by an administrator at my health care facility where I was scheduled to receive it. I asked for an explanation, after lengthy debate was told none would be forthcoming,,,,as she did not why either.

Tried to do some online research,,,,found one very sketchy reference suggesting some 2 years ago that payments for procedure may be dropped from Medicare. I felt that possibly because was inferior to other scans that had come on market.

I then scheduled another type of Pet 18 scan with a different contrast agent that was paid by Medicare,,,,”NM pet ct skull to thigh”. Provided a very good report,,,not that I liked the finding however.

[kick-prostate-cancer in reply to Sxrxrnr1]

What does the NM stand for? (Nuclear Medicine?)

[Sxrxrnr1 in reply to kick-prostate-cancer]

I hope so!

[kick-prostate-cancer]

GREAT NEWS! I looked for an independent scan location, and found Northern California PET Imaging Center (our hospital in Reno is the only place that could do the F18 Scan). Their price is only $1900 ... including the Radiologist's reading and report out!! Compared to the $8000 at Renown. EUREKA!!!