MRI vs PSMA Pet scan

[WhistlersMother59]

Hello,

Medicare will pay for 2 mri's in a persons lifetime.

The doc recommends an mri at the local hospital, should I insist on a referal for a psma pet scan in Denver, is it worth the 4 1/2 hour drive to get there?

Thanks!

[6357axbz]

I’m on Medicare and also have a BCBS Medicare Supplement Plan F. I’ve had many MRIs and never paid a cent.

If you’re trying to identify PCa related, distant metastases then PSMA

[Tall_Allen]

I'm confused: MRI or PSMA PET/CT? they are different and used for different purposes. What treatment decision are you trying to make?

[WhistlersMother59 in reply to Tall_Allen]

to check for metastatic cancer outside of his prostate.

Psa has been doubling and now above 4.

[Tall_Allen in reply to WhistlersMother59]

Then he needs a PSMA PET/CT, not an MRI.

[swwags]

Agree with TA, he needs a PSMA scan, not an MRI but to clear up your confusion:

"Medicare does not set annual or lifetime limits on how many MRI scans a Medicare beneficiary can receive. It covers MRIs each time a Medicare-approved doctor orders them, so long as the scans are still reasonable and medically necessary.

Doctors may recommend repeated MRIs to keep an eye on certain health conditions. For example, Medicare guidelines note that MRIs are covered to monitor bone tumors or the death of bone tissue due to a lack of blood supply. "

[TeleGuy]

If Denver is a 4.5 hour drive, then consider also consulting with an oncologist. The University of Colorado Anschutz campus does PSMA PET scans and they have some excellent oncologists.

[LowT]

Every case is unique. In my case I’ve had two negative PSMA PET scans while 2 prostate MRIs with and without contrast shows new enhancing nodule in prostate bed.

But, My PSA is much lower than yours.

[ImaSurvivor1]

It is certainly not true that Medicare has a limit of 2 MRIs per lifetime. Somebody may be imposing such a limit (a Medicare Advantage provider, a medical group, etc.), but it's not Medicare's limit.