CTSU Menu Trials Included in Medicare Pilot

On 1/28/05, the Centers for Medicare and Medicaid Services (CMS) issued a National Coverage Determination (NCD) covering the off-label use of certain anti-cancer drugs in identified clinical trials of colorectal cancer and other cancer types. Coverage is provided for clinical care associated with study participation for Medicare patients enrolled in 9 specific NCI trials, many of which are included on the CTSU menu.

The trials that are currently on, or are slated for activation on, the CTSU menu are:
  • CALGB 80405
  • ECOG 2204
  • ECOG 5202
  • ECOG 5204
  • NSABP R-04 (Amd. 2)
  • RTOG 0522
  • SWOG 0502.

    Please check under the "Miscellaneous" section of each of the above trials' protocol pages (on the Members' web site - for information regarding this NCD, including general billing instructions and related protocol-specific information. Information will be posted there as it becomes available from the Groups, NCI and CMS.

    Please click here to view:
    CMS Physician Tools Overview
    CMS Billing Overview
    CMS Drug Billing Information for Pharmacists
    CMS Imaging Test Billing Information.

    For more information, please view the following brief slide set:
    CMS-NCI Pilot Project

    Or, visit this NCI web page:
    Clinical Trials Covered Under the Medicare Anti-Cancer Drug National Coverage Decision