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NCD 220.6.20 · version 2

NCD 220.6.20: Beta Amyloid Positron Tomography in Dementia and Neurodegenerative Disease (RETIRED)

QuickIntell editorial content · Legacy registry date · Review not verified

Data effective
Data currency: Medicare Coverage Database release of September 24, 2026 (effective September 20, 2026). Next CMS release: weekly (every Thursday) for the MCD; quarterly for lab NCD code lists.

Key facts for NCD 220.6.20

Benefit category
Diagnostic Tests (other)
Effective date
10/13/2023
Implemented 12/19/2023
Transmittal
Transmittal 12364
Versions published
2
Manual chapter
220
NCD Manual (Pub. 100-03)

TL;DR

NCD 220.6.20 sets Medicare's national policy for beta amyloid positron tomography in dementia and neurodegenerative disease (retired) under the benefit category "Diagnostic Tests (other)", effective 10/13/2023 and implemented 12/19/2023. (Rev. 12364; Issued:11-16-23; Effective:10-13-23; Implementation:12-19-23) It has been revised 1 time since publication and binds every Medicare Administrative Contractor nationally.

Indications and limitations of coverage

(Rev. 12364; Issued:11-16-23; Effective:10-13-23; Implementation:12-19-23)

Effective October 13, 2023, CMS removed NCD 220.6.20, ending CED for PET beta amyloid imaging and permitting Medicare coverage determinations for PET beta amyloid imaging to be made by the Medicare Administrative Contractors under section 1862(a)(1)(A) of the Social Security Act.

Text reproduced from the CMS Medicare Coverage Database record for NCD 220.6.20 version 2. View the original on cms.gov.

Revision history

11/2023 - The purpose of this Change Request (CR) is to announce that effective October 13, 2023, CMS removed NCD 220.6.20 from Publication 100-03, the NCD Manual, ending coverage with evidence development (CED) for positron emission tomography (PET) beta amyloid imaging and permitting Medicare coverage determinations for PET beta amyloid imaging to be made by the Medicare Administrative Contractors under section 1862(a)(1)(A) of the Social Security Act.

10/2022 - Transmittal 11546, dated August 4, 2022, is being rescinded and replaced by Transmittal 11636,

dated, October 5, 2022, to remove ICD-10 dx codes added in error to NCD 150.3, business requirement 12842.4, and restore ICD-10 dx C91.92 removed in error to NCD 110.23, business requirement 12842.3. All other information remains the same. ( TN 11636 ) (CR12842)

08/2022 - The purpose of this Change Request (CR) is to provide a maintenance update of ICD-10 conversions and other coding updates specific to NCDs. ( TN 11546 ) (CR12842)

07/2017 - This Change Request (CR) constitutes a maintenance update of International Code of Diseases, Tenth Revision (ICD-10) conversions and other coding updates specific to National Coverage Determinations (NCDs). These NCD coding changes are the result of newly available codes, coding revisions to NCDs released separately, or coding feedback received.

Previous NCD coding changes appear in ICD-10 quarterly updates that can be found at: https://www.cms.gov/Medicare/Coverage/CoverageGenInfo/ICD10.html , along with other CRs implementing new policy NCDs. Edits to ICD-10 and other coding updates specific to NCDs will be included in subsequent quarterly releases and individual CRs as appropriate. No policy-related changes are included with the ICD-10 quarterly updates. Any policy-related changes to NCDs continue to be implemented via the current, long-standing NCD process. ( TN 1875 ) (CR10184)

11/2016 - This change request (CR) is the 9th maintenance update of ICD-10 conversions and other coding updates specific to national coverage determinations (NCDs). The majority of the NCDs included are a result of feedback received from previous ICD-10 NCD CR7818, CR8109, CR8197, CR8691, CR9087, CR9252, CR9540, and CR9631. Some are the result of revisions required to other NCD-related CRs released separately.

Edits to ICD-10 and other coding updates specific to NCDs will be included in subsequent, quarterly releases as needed. No policy-related changes are included with these updates. Any policy-related changes to NCDs continue to be implemented via the current, long-standing NCD process. ( TN 1753 ) (CR9751)

08/2016 - This change request (CR) is the 9th maintenance update of ICD-10 conversions and other coding updates specific to national coverage determinations (NCDs). The majority of the NCDs included are a result of feedback received from previous ICD-10 NCD CR7818, CR8109, CR8197, CR8691, CR9087, CR9252, CR9540, and CR9631. Some are the result of revisions required to other NCD-related CRs released separately.

Edits to ICD-10 and other coding updates specific to NCDs will be included in subsequent, quarterly releases as needed. No policy-related changes are included with these updates. Any policy-related changes to NCDs continue to be implemented via the current, long-standing NCD process. ( TN 1708 ) (CR9751)

03/2014 - Transmittal 160, dated February 6, 2014 is being rescinded and replaced by Transmittal 164, dated March 27, 2014 to update the reference to the correct CPM chapter 13 in the first business requirement. All other information remains the same. Effective date: 09/27/2013. Implementation date: 07/07/2014. ( TN 164 ) (CR8526)

02/2014 - The purpose of this Change Request (CR) is that effective for claims with dates of service on or after, September 27, 2013, Medicare will only allow coverage for PET Aß imaging (one PET Aß scan per patient) through coverage with evidence development (CED) to: (1) develop better treatments or prevention strategies for AD, or, as a strategy to identify subpopulations at risk for developing AD, or (2) resolve clinically difficult differential diagnoses (e.g., frontotemporal dementia (FTD) versus AD) where the use of PET Aß imaging appears to improve health outcomes, when the patient is enrolled in an approved clinical study under CED. Effective date: 09/27/2013. Implementation date: 07/07/2014. ( TN 160 ) (CR8526)

How this NCD shows up on remittances

A service denied under a National Coverage Determination returns CARC 50 (not deemed medically necessary) with remark N386 (decision based on an NCD); a denial citing a local policy instead carries N115. Because NCDs bind nationally, the appeal path is documentation that the patient meets the indications above, not a contractor-policy argument.

How QuickIntell applies NCD 220.6.20

QuickAuth checks the ordered service and diagnosis against NCD and LCD criteria before the encounter, QuickCode validates the diagnosis pairing on the claim, and QuickRCM routes CARC 50 denials with the policy text and the covered-code list attached so the appeal starts with evidence.

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Frequently asked questions — NCD 220.6.20

What does NCD 220.6.20 cover?

(Rev. 12364; Issued:11-16-23; Effective:10-13-23; Implementation:12-19-23) The full indications and limitations are reproduced on this page from the CMS Medicare Coverage Database.

When did NCD 220.6.20 take effect?

The current version (2) is effective 10/13/2023, implemented 12/19/2023, published in transmittal 12364. CMS lists 2 versions of this NCD.

Does a Local Coverage Determination override NCD 220.6.20?

No. A National Coverage Determination binds all Medicare Administrative Contractors; an LCD can only address services or circumstances the NCD leaves open. Claims denied under this NCD typically return CARC 50 with remark N386 (NCD) rather than N115 (LCD).

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-02. Verify against the primary file before billing or contracting decisions.

Disclaimer

This page reproduces the CMS National Coverage Determination text and, for laboratory NCDs, the CMS ICD-10 edit lists, as an operational reference. Coverage decisions depend on the full policy, the claim and the contractor; nothing here is legal, clinical or billing advice. CPT codes are shown as numbers only; CPT descriptors are copyright AMA.