Medicare to Expand Coverage for Colorectal Cancer Screening
By Emma Freer

Medicare patients soon will benefit from expanded coverage of colorectal cancer screening tests, following advocacy by the Texas Medical Association and others in organized medicine.  

Starting Jan. 1, the Centers for Medicare & Medicaid Services (CMS) gradually will reduce coinsurance payments for Medicare patients who undergo unplanned colorectal screening tests until 2030, when the federal agency will waive such copayments altogether. 

Currently, Medicare patients don’t pay for planned colorectal screening tests. However, any procedures stemming from such tests – such as diagnostic colonoscopies or flexible sigmoidoscopies – incur a 20% copayment. 

Between 2023 and 2026, Medicare patients will pay 15% of the cost for any additional screening, according to CMS. Between 2027 and 2029, their share will drop to 10%. 

TMA endorsed this policy change in a Sept. 6 letter to CMS regarding its proposed 2023 Medicare physician fee schedule.  

“TMA continues to support the elimination of coinsurance for [these procedures] as this is sound policy that will reduce the financial burden facing Medicare [patients] whose screenings result in a diagnostic procedure,” the association wrote. “Elimination of coinsurance also will promote utilization of colorectal cancer screenings that save lives.”  

In addition to this change, CMS will reduce the minimum age for colorectal cancer screening from 50 to 45, effective Jan. 1, heeding recommendations from the U.S. Preventive Services Task Force.  

TMA policy supports legislation requiring coverage for colorectal cancer screening that follows the most recently established national guidelines.  

Colorectal cancers are projected to be the second-leading cause of cancer deaths in Texas this year, with 4,447 expected deaths, according to the Texas Cancer Registry.  

Last Updated On

December 02, 2022

Originally Published On

December 02, 2022

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Emma Freer

Reporter

(512) 370-1383
 

Emma Freer is a reporter for Texas Medicine. She previously worked in local news, covering city politics, economic development, and public health. A native Clevelander, she graduated from Columbia Journalism School and the University of St. Andrews.

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