CMS aims to end coinsurance when CRC screenings become diagnostic tests by 2030

CMS plans to phase out coinsurance for colorectal cancer screenings when physicians identify a polyp for removal, which currently are categorized as diagnostic tests.

Medicare beneficiaries do not pay coinsurance for CRC screenings. However, if the gastroenterologist identifies a polyp for removal, the screening becomes a diagnostic test, which does include coinsurance.

The proposed 2022 Physician Fee Schedule, issued July 13, gradually would reduce the percentage of coinsurance when CRC screenings become diagnostic tests over the next decade. Beneficiaries would be responsible for 20 percent in 2022, 15 percent in 2023 to 2026, and 10 percent in 2027 to 2029.

By 2030, coinsurance would be eliminated for Medicare beneficiaries who undergo a CRC screening that becomes a diagnostic test.

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