CMS finalizes 2022 rule for colorectal cancer screenings

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CMS finalized a rule Nov. 2 that changes the requirement of coinsurance when practitioners at hospital outpatient departments and ASCs remove polyps during a colorectal cancer screening. 

As it stands, the removal of polyps changes the screening test to a diagnostic test, meaning that coinsurance is required if polyps are removed during a colorectal screening. 

The new rule reduces the amount of coinsurance a beneficiary will pay for such services over time.

Beginning Jan. 1, the coinsurance paid for planned colorectal cancer screening tests with additional procedures will be a percentage of the charge for the service— 20 percent for calendar year 2022, 15 percent for calendar years 2023 through 2026 and 10 percent for calendar years 2027 through 2029. 

The coinsurance requirement will be gradually reduced, and beginning Jan. 1, 2030, the addition will be zero percent.

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