Cost for reading PET/CTs

[thesauce]

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Our group is looking at purchasing a PET/CT and I’m wondering a couple things:

1. Does NM read both the PET and CT portions of the imaging?

2. What is the ballpark cost (per study) to read a standard PET/CT if we were to contract with a NM group?

 

[Tiger100]

The professional fee for PET-CT depends on patient's insurance and its CPT code is defined by CMS.

 

[JPEGpeggy]

Depends on the center. Usually, PET/CT without CT contrast, both PET and CT images can be read by nuclear medicine physician. A PET/CT with CT contrast, the PET portion is read by nuclear medicine and the CT portion by radiologist. A nuclear radiology can read both PET/CT with and without contrast.

 

[maxxor]

Our group is looking at purchasing a PET/CT and I’m wondering a couple things:

1. Does NM read both the PET and CT portions of the imaging?

2. What is the ballpark cost (per study) to read a standard PET/CT if we were to contract with a NM group?

1. NM only boarded people will be comfortable looking at the low dose attenuation correction CTs. They won’t want anything to do with contrast CT or diagnostic quality CTs if requested by your referrings.

2. There’s multiple ways to do a PET. You can do a standard attenuation correction only PETCT, and bill it out as that. It’s around 3.4 rvus for modifier 26 (I’m not sure how it changed with most recent revisions for 2021).

You can also do PET with a diagnostic CT. That’s billed as a PET only CPT with diagnostic CT CPTs of the various regions requested by referring. The pet only is about 2.6 rvu for mod 26. The diagnostic CT cpts are whatever they are.

The greatest flexibility is a Nuc Rad who can handle both scenarios (someone dual boarded or someone who is ABR NucRad CAQ).

3. As far as ballpark costs, that’s a negotiation based on your payer mix and payer contracts. I assume if your group is buying the PETCT, you’d be billing the TC and letting the NM group bill the PC themselves or you bill the Global and pay them a per study rate of whatever amount you guys think is fair.