A recent Centers for Medicare and Medicaid Services (CMS) announcement declared a positive local coverage decision (LCD) for patients undergoing unilateral focused ultrasound thalamotomy for tremor-dominant Parkinson’s disease. Palmetto GBA, a Medicare Administrative Contractor (MAC) covering many states in the Southeast, will now cover the procedure for patients treated on or after February 10. 

insurance update graphicUS Medicare coverage is divided into 12 regional MACs that are tasked with administering local Medicare plans. Nine of these currently offer coverage for patients seeking focused ultrasound treatment for essential tremor; the remaining three are expected to finalize coverage in the early summer of 2020.

Now, Palmetto GBA – which covers Alabama, Georgia, Tennessee, South Carolina, North Carolina, Virginia, and West Virginia – has agreed to extend this coverage to include focused ultrasound treatment for medication-refractory tremor-dominant Parkinson’s disease.* This is the first US reimbursement available for these patients.

“We’ve heard from several treatment sites around the country that they’re already treating patients with Parkinson’s tremor, even though it was not previously reimbursed by Medicare,” says Michael Broad, the Foundation’s Director of Global Relations. CMS logo“Clearly, we’d like to see as many patients covered for this procedure as possible. Because of this, we’re hoping to see a similar trend to that for essential tremor, where approval by the first of the MACs creates a domino effect, with many of the other MACs approving coverage in relatively short order.”

Since not all treatment centers accept Medicare patients, people seeking this treatment should call the facility and inquire about this possibility before making any plans.

*Not all Parkinson's disease is considered tremor-dominant, so we encourage all Parkinson’s disease patients to consult their physician to determine if their disease can be considered tremor-dominant. 

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