Online assessment available on SSM Health website
to help determine patient risk and eligibility for coverage
Mt. Vernon, IL (August 2, 2016) – SSM Health is offering low-dose computed tomography (CT) lung cancer screenings, which are covered for the first time ever by the Centers for Medicare and Medicaid. CMS is now accepting claims for low-dose CT lung cancer scans for individuals age 55 to 77 years old, who meet
criteria (also see below).
The low-dose CT lung cancer screenings are available at both SSM Health Good Samaritan Hospital – Mt. Vernon and SSM Health St. Mary's Hospital – Centralia; their imaging centers are accredited by the American College of Radiology. These preventative screenings are key to early detection and survival of lung cancer, which is the leading cause of cancer death in the United States, claiming more than 200,000 lives each year, according to the American Cancer Society.
Anyone interested in learning if they might qualify for the covered lung cancer screenings, should complete SSM Health's online pre-authorization form and a brief risk assessment questionnaire at
"We're encouraging patients, who receive a high-risk result from their online assessment to make an appointment with their primary care doctor to talk about a lung cancer screening, because they may qualify for a covered screening," said radiologist Ryan Willis, MD. "The assessment will take only a few minutes to complete."
During appointments with their primary care doctors, SSM Health recommends that patients discuss the following:
- The risk vs. benefits of screening
- Total cost and insurance coverage
- How to locate a screening facility
- What screening results mean
- Next steps after a lung cancer screening
Much of the research that enabled CMS to begin including low-dose CT lung scans among its covered services was conducted by members, including SSM Health, of the
International Early Lung Cancer Action Program. Key findings include:
Curability of Stage I lung cancers is 80-90%
Annual CT screening allows at least 80% of lung cancers to be diagnosed at clinical Stage I
CT screening creates a counseling opportunity that results in greater smoking cessation
Cost of CT screening for lung cancer compare favorably with breast, cervical, and colon cancer screenings
The New England Journal of Medicine reported in late 2014 that screening high-risk patients, using annual low-dose CT screening, resulted in 85 percent of those diagnosed to be in the earliest stages of the disease. The publication also reported that a large randomized trial showed that low-dose CT screening reduced the risk of lung-cancer death by 20% among long-time smokers.
"SSM Health is proud to have been involved for the past several years in the International
Early Lung Cancer Action Program, which was instrumental in helping CMS make these recent coverage changes," Willis said. "Our board-certified doctors, nurse navigators and supportive care professionals offer care tailored to meet the specific needs of our lung cancer patients, as well as their overall health."
Before scheduling a lung cancer screening appointment, patients will need a written order from their primary care doctor for a "low-dose CT scan of the chest." Those who do not have a primary care provider can find one and schedule an appointment online at
Anyone interested in learning more about low-dose CT lung cancer scans can call SSM Health at 618.899.1894 or 618-436-8277.
To be eligible for free lung cancer screenings under the new CMS guidelines, patients must meet the following criteria:
Age 55-77 years;
Asymptomatic (no signs or symptoms of lung disease);
Tobacco smoking history of at least 30 pack-years (one pack-year = smoking one pack per day for one year; 1 pack = 20 cigarettes);
Current smoker or one who has quit smoking within the last 15 years; and
A written order for LDCT lung cancer screening that meets specific criteria identified by the Centers for Medicare and Medicaid.
The written order must be obtained during a lung cancer screening counseling and shared decision making visit, furnished by a physician or qualified non-physician practitioner.
Shared decision making visits should include counseling on the importance of annual LDCT lung cancer screening; maintaining cigarette smoking abstinence if former smoker or smoking cessation if current smoker; and, if appropriate, offering additional Medicare-covered tobacco cessation counseling services.