Key Points
- Medicare patients in Kentucky, Ohio, and ten states in the Northeast will soon have access to focused ultrasound therapy for tremor-dominant Parkinson’s disease.
- A total of 19 states have announced coverage for the treatment under Medicare.
- Please remember to make sure your nearest treatment center accepts Medicare patients.
The Centers for Medicare and Medicaid Services (CMS) have announced expanded positive local coverage decisions (LCD) for patients undergoing focused ultrasound treatment for tremor-dominant Parkinson’s disease.
US Medicare coverage is divided into 12 regional Medicare Administrative Contractors (MACs) that are tasked with administering local Medicare plans. Two MACs – CGS Administrators (CGS) and National Government Services (NGS) – will roll out coverage of the procedure over the next two months.
Although all MACs currently offer coverage for patients seeking focused ultrasound treatment for essential tremor, Palmetto GBA – which covers Alabama, Georgia, Tennessee, South Carolina, North Carolina, Virginia, and West Virginia – was the first, in February 2020, to extend this coverage to include focused ultrasound treatment for medication-refractory tremor-dominant Parkinson’s disease.*
CGS, which covers patients in Kentucky and Ohio, will provide coverage to patients treated on or after March 3, 2021. NGS, which covers patients in Connecticut, Illinois, Massachusetts, Maine, Minnesota, New Hampshire, New York, Rhode Island, Vermont, and Wisconsin, will provide coverage to patients treated on or after April 15, 2021.
“When Palmetto first announced coverage, we were hoping to see the same domino effect that we saw for coverage of essential tremor, where the other MACs began to approve coverage in relatively short order after the first one established the trend,” said Michael Broad, the Foundation’s Director of Global Relations. “Thankfully, this is what appears to be happening with Parkinson’s tremor. The addition of CGS and NGS now brings the total covered Medicare beneficiaries to more than 20 million people.”
Importantly, not all treatment centers accept Medicare patients, so people seeking this treatment should call the facility and inquire about this possibility before making any plans. See a list of all treatment centers in the US >
*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.