NOPR


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National Oncology PET Registry (NOPR)

Why needed?

The National Oncologic PET Registry (NOPR) was developed in response to the Centers for Medicare and Medicaid Services (CMS) proposal to expand coverage for PET with F-18 fluorodeoxyglucose (FDG) for oncology indications not otherwise eligible for Medicare reimbursement. Medicare reimbursement for oncology indications covered under the NOPR can be obtained by facilities that have registered with the NOPR to participate and fulfill NOPR program requirements for data submission.

Proof it works

  • The original NOPR began accepting patient registrations in May 2006 and closed April 2009 with over 125,000 patients enrolled by 1,815 facilities. (Note: the NOPR subsequently continued operations by establishing a new database which began in April 2009)
  • The NOPR investigators proved PET imaging had an impact on referring physicians’ intended patient management
  • Based on this data, CMS expanded coverage of PET imaging for initial evaluation of cancer to nearly all types of cancer 1,2
  • However, for cancer treatment monitoring, restaging and the detection of suspected recurrence, there remains a number of cancer types where PET will only be covered by CMS through the NOPR (see NOPR indications.1,2)
  • In addition, CMS announced it will cover NaF-18 PET bone scans to identify bone metastasis of cancer under the Coverage with Evidence Development (CED) framework,1,2 a registry that is expected to become operational in Q4 of 2010.

 

NOPR tracking tool

The NOPR tracking tool can be used to monitor the status of the patient in relation to the various NOPR required forms including when the patient was billed and payment received.

NOPR patient status tracker

References

  1. Medicare National Coverage Determinations Manual
    Chapter 1; Part 4; Section 220.6 - PET Scans
    http://www.cms.hhs.gov/manuals/downloads/ncd103c1_Part4.pdf

  2. Medicare Claims Processing Manual
    Chapter 13; Section 60 - PET Scans
    http://www.cms.hhs.gov/manuals/downloads/clm104c13.pdf