Reimbursement

Reimbursement

Reimbursement Support for Neuraceq®

Neuraceq® is an FDA-approved radioactive diagnostic agent for the detection of amyloid plaques in the brain of adult patients with cognitive impairment who are being evaluated for Alzheimer’s disease and other causes of cognitive decline. Neuraceq® is used in clinical routine and is also a powerful diagnostic tool for the appropriate characterization of patients assessed for treatment eligibility with newly approved anti-amyloid drugs.

We Are Here to Support You

For questions related to coding, coverage, or payment using Neuraceq® for Amyloid PET imaging, contact our Reimbursement team.

*The ultimate coverage or reimbursement determination is up to the payer. LMI does not guarantee coverage or payer reimbursement for product treatment or administration. LMI cannot guarantee success in obtaining reimbursement, nor can it submit appeals on behalf of providers or patients.

Contact the Reimbursement Team >

Reimbursement Resources

Reimbursement Guide

Includes Neuraceq® billing codes and details about access and reimbursement support services

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Prior Authorization Checklist

If Prior Authorization is required, see guidance on what is needed to submit a request

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IDTF/Non-Hospital Sample Claim Form

View a sample claim form for a physician office and Independent Diagnostic Testing Facility (IDTF)

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Hospital Outpatient Sample Claim Form

View guidance for a sample claim form for a Hospital Outpatient facility

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Calendar Year 2026 – Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Proposed Rule (CMS 1834-P)

On November 25, 2025, The Centers for Medicare & Medicaid Services (CMS) finalized changes to the payment threshold for all diagnostic radiopharmaceuticals from $630 to $655 under OPPS.

CMS also decided to continue with Mean Unit Cost (MUC) for diagnostic radiopharmaceuticals above $655.

We will continue to work with industry and CMS to strongly encourage Average Sales Price (ASP) to be used in 2027.

View the rule here >

Centers for Medicare & Medicaid Services (CMS) retires the NCD, which eliminates CED and the 1 scan per lifetime patient limit

October 13, 2023

Centers for Medicare & Medicaid Services (CMS) retires the NCD, which eliminates CED and the 1 scan per lifetime patient limit

Read more about this CMS news >

Neuraceq® - Product Indications And Use

PRODUCT INDICATIONS AND USE: NEURACEQ is a radioactive diagnostic drug indicated for positron emission tomography (PET) of the brain to estimate amyloid beta neuritic plaque density in adults with cognitive impairment for:  Evaluation of Alzheimer’s disease (AD) and other causes of cognitive decline, and selection of patients who are indicated for amyloid beta-directed therapy as described in the prescribing information of the therapeutic products.

 

NEURACEQ IMPORTANT SAFETY INFORMATION:

 

CONTRAINDICATIONS: None

WARNINGS AND PRECAUTIONS:

  • Risk for Image Misinterpretation and other Errors
    NEURACEQ Risk of Image Misinterpretation and Other Errors: Image interpretation errors have been observed. [see Section 5.1 of the full prescribing information]
  • Radiation Risk
    NEURACEQ, similar to other radiopharmaceuticals, contributes to a patient's overall long-term cumulative radiation exposure. Long-term cumulative radiation exposure is associated with an increased risk of cancer. Ensure safe handling to protect patients and health care workers from unintentional radiation exposure [see Dosage and Administration in the full prescribing information].

ADVERSE REACTIONS:

  • The most commonly reported adverse reactions in clinical trials were injection site pain (3.4%), injection/application site erythema (1.7%), and injection site irritation (1.1%).

USE IN SPECIFIC POPULATIONS:

  • Pregnancy : All radiopharmaceuticals, including NEURACEQ, have a potential to cause fetal harm depending on the stage of fetal development and the magnitude of the radiopharmaceutical dose. If considering NEURACEQ administration to a pregnant woman, inform the patient about the potential for adverse pregnancy outcomes based on the radiation dose from the drug and the gestational timing of exposure.
  • Lactation : Temporarily discontinue breastfeeding. A lactating woman should pump and discard breast milk for 24 hours after NEURACEQ administration.
  • Pediatric Use:  The safety and effectiveness of NEURACEQ have not been established in pediatric patients.
  • Geriatric Use: No overall differences in safety or effectiveness were observed between subjects 65 years of age and older and younger adult subjects.

OVERDOSAGE:
 In the event of administration of a radiation overdose with NEURACEQ, the absorbed organ dose to the patient should be reduced by increasing elimination of the radionuclide from the body by inducing frequent micturition. Prior to NEURACEQ administration, please read the full Prescribing Information for additional Important Safety Information.

SUSPECTED ADVERSE REACTIONS: please report to: https://www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-event-reporting-program

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