National Coverage Analysis (NCA) Tracking Sheet

Magnetic Resonance Imaging (MRI)

CAG-00399R4

Issue

Magnetic resonance imaging (MRI) is a noninvasive method of graphically representing the distribution of water and other hydrogen-rich molecules in the human body. MRI is a useful diagnostic imaging modality that is capable of demonstrating a wide variety of soft-tissue lesions with contrast resolution equal or superior to computerized tomography (CT) scanning in various parts of the body.

Section 220.2 of the National Coverage Determination (NCD) Manual, effective since 1985, established coverage of MRI for a number of uses. The policy has been expanded over the years; CMS last reconsidered this NCD in 2011. Aside from an exception for MRI furnished in approved clinical studies of implanted pacemakers and implantable cardioverter defibrillators (ICDs) under the Coverage with Evidence Development (CED) paradigm, MRI is generally non-covered when certain patient-specific contraindications are present, including, among others, patients who have implanted cardiac pacemakers.

CMS is opening this national coverage analysis to reconsider coverage indications for MRI. This reconsideration is limited to MRI and does not include any coverage determination about magnetic resonance (MR) conditional pacemakers, MR conditional ICDs, or any other pacemaker or ICD. See Medicare’s NCD on Cardiac Pacemakers at 20.8 and Implantable Automatic Defibrillators at 20.4 of the NCD Manual.

National Coverage Determinations

Benefit Category

Diagnostic Services in Outpatient Hospital
Diagnostic Tests (other)

Requestor Information

Requestor Name Requestor Letter
Internally generated N/A
N/A

Important Dates

Formal Request Accepted and Review Initiated
07/12/2017
Expected NCA Completion Date
04/11/2018
Public Comment Period
07/12/2017 - 08/11/2017
Proposed Decision Memo Due Date
Proposed Decision Memo Released
01/11/2018
Proposed Decision Memo Public Comment Period
01/11/2018 - 02/10/2018
Decision Memo Released
04/10/2018
Comments for this NCA
View Public Comments

Contacts

Lead Analysts
Kim Long
kimberly.long@cms.hhs.gov
410-786-5702
Daniel A. Canos, PhD, MPH
Lead Medical Officers
Joseph Hutter, MD, MA

Medicare Benefit Category Determination Date

Actions Taken

July 12, 2017

CMS initiates this national coverage analysis for reconsideration of Section 220.2 of the NCD Manual. The initial 30-day public comment period begins with this posting date, and ends after 30 calendar days.

CMS considers all public comments and is particularly interested in comments that include clinical studies, expert consensus statements, and other scientific evidence.

Instructions on submitting comments can be found at: http://www.cms.gov/Medicare/Coverage/InfoExchange/publiccomments.html. You can also submit a public comment by clicking on the highlighted word comment in the title bar at the top of this page. We strongly urge that all public comments be submitted through this website. Please do not submit personal health information in public comments. Comments with personal health information may not be posted to the website.

January 11, 2018

January 22, 2018

The Coverage & Analysis Group is in a furlough status as of Saturday, January 20, 2018, due to an absence of federal appropriations.

You may still submit public comments on this NCA until February 10. They will be held until a continuing resolution or a fiscal year 2018 appropriation for the federal government has been approved.

April 10, 2018