In order for a patient to be qualified for a low-dose CT of the chest for lung cancer screening a patient must meet the following high-risk criteria:
- Between the ages of 55 and 77
- Free from symptoms of cancer
- A current smoker or quit within the past 15 years
- Have at least a 30 pack year history
- Willing and able to undergo curative treatments
Costs & Coverage
In February 2015, the Centers for Medicaid and Medicare Services (CMS) added low-dose CT lung screening to their preventative service benefits for patients who meet eligibility criteria. CMS and most private insurers will reimburse for LDCT lung screening for patients that meet the defined high-risk criteria above. Read the CMS memo.
No matter what your patient's financial or insurance coverage may be, we will work with them to meet their needs. We offer a sliding scale rate based off of a patient's financial status.
Shared Decision Making Visit
CMS requires that a shared decision making and counseling visit must take place in order for coverage of a low-dose CT scan of the chest to screen for lung cancer. In an effort to provide comprehensive education to patients and partner with referring providers, we have a dedicated Lung Cancer Screening nurse practitioner who will perform the shared decision making visit and all required documentation requirements. We must receive a referral to the lung cancer screening program in order for the nurse practitioner to perform this visit.
Completing the Referral Process
If your patient is interested in a lung cancer screening, the next step is to place a referral to the program. The Lung Cancer Screening Program nurse practitioner will complete the shared decision making and counseling visit with your patient, provide comprehensive education on risks and benefits, and contact you and the patient with results of the scan.
UVA providers can place a referral in EPIC using the “Lung Cancer Screening” referral.
Providers outside of the UVA system can use the following referral form that can be printed, filled in, and faxed:
Once a referral has been placed, our schedulers will contact your patient. Our schedulers can be contacted at 434-924-9333. Exams can be scheduled at one of the following four locations:
- UVA Hospital
- Emily Couric Clinical Cancer Center
- UVA Imaging at Fontaine
- UVA Imaging at Zion Crossroads
After Your Patient is Screened
Our dedicated Lung Cancer Screening Program nurse practitioner will contact patients with results and discuss recommendations and follow-up.
All patients will be monitored by our nurse practitioner to ensure proper follow-up. It’s important for patients to comply with annual screenings to gain the life-saving benefits of lung cancer screening. More information on the follow-up recommendations can be found in the Lung-RADS or NCCN guidelines. (pdfs attached in this email, please make them a downloadable link for “Lung-RADS” and “NCCN guidelines”.