CMS: Reduced Coinsurance for Procedures Related to Colorectal Cancer Screening Tests

Under current CMS guidelines, planned colorectal screening tests are free; however, when add-on procedures are performed during the colorectal cancer screening encounter, the patient is required to pay a coinsurance.

The newsletter states beginning January 1, 2023, CMS will gradually reduce coinsurance for procedures performed in connection with a colorectal screening test, as a result of the screening, or at the same encounter as the screening.

According to the newsletter, the gradual reduction will be phased according to the timetable below:

• 2023-2026, coinsurance is 15%
• 2027-2029, coinsurance is 10%
• Beginning 2030, no coinsurance

For more information about the coinsurance update, please review CMS change request (CR)12656:

https://www.cms.gov/files/document/mm12656-changes-beneficiary-coinsurance-additional-procedures-furnished-during-same-clinical.pdf