Reimbursement Issues

Most insurance companies pay for clinically indicated PET procedures. To be clinically indicated, the PET scan must be potentially beneficial in providing information supportive of a diagnosis or monitoring certain conditions.

Many insurance companies have coverage policies for certain clinical situations where PET scans have been proven to be useful. Since PET is a growing field, the data sometimes does not catch up with the payers coverage policy, so just because the indication is not on the standard coverage list does not mean that the insurance company will not pay for a clinically indicated PET scan.

When the scan is in the process of being pre-authorized, it is a good idea for the physician to provide clinical information to the insurance company, including articles that support the use of PET for that indication. Many coverage policies are local, so it is important to determine the coverage policies from the major payers in your area.

We participate with most health insurance plans. The field of PET has been emerging into clinical diagnostic medicine and is approved by many insurance carriers for coverage.

Patients are responsible for deductibles, co-payments and remaining balances. Payment is expected when services are rendered and all patients are responsible to supply an insurance card and a written referral from their physician (if needed).

Please contact our office with questions regarding insurance and coverage for PET scans.


2855 Telegraph Ave., Suite 100
Berkeley, CA 94705
Tel: 510-204-9400
Fax: 510-204-0600

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