6 things to know about colonoscopy cost & what a reimbursement cut would mean

Colonoscopy has come under attack as an unnecessarily expensive procedure and much of the public scrutiny has focused on payment to physicians. But, should physicians be paid less for the procedure?

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Here are six things to know about the cost of colonoscopy and the potential impact of a physician reimbursement cut, according to an AJMC Managed Markets Network report.

•    Medicare paid physicians $239 million in professional fees for 1.1 million screening and diagnostic colonoscopies performed in 2012.
•    The 2014 Medicare Physician Fee Schedule reduced reimbursement for upper endoscopy procedures and colonoscopy may face similar cuts in 2015.
•    The professional fee for colonoscopy is approximately 20 percent of the total cost of colonoscopy.
•    Colonoscopy hospital outpatient department facility fee is more than double the professional fee.
•    Taking into consideration how small a percent the professional fee is, reducing the physician reimbursement would not have a large impact on overall colonoscopy cost.
•    Reducing physician compensation for colonoscopy may negatively affect access and utilization of the procedure.

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