Practice Support Services

Colorectal Cancer Screening Reimbursement Changes for 2023

Written by Leslie D McDowell, DNP, ANP-BC, RN | Jan 4, 2023 1:00:00 PM

 

  • Colorectal cancer was the 2nd leading cause of cancer deaths in North Carolina in 2019.

  • Data from 2020 shows that 20% of people aged 50-75 in the US have never been screened for this disease.

  • In March 2021, the US Preventive Services Task Force (USPSTF) changed screening recommendations to lower the age to begin screening from 50 to 45.

CMS and Blue Cross and Blue Shield of North Carolina have changed reimbursement guidelines for Colorectal Cancer Screening. These changes include things like reduced co-insurance when a screening colorectal cancer procedure becomes diagnostic or therapeutic; and for Medicare, that colorectal cancer screening tests include a follow-on screening colonoscopy if a non-invasive stool-based test returns a positive result.

Click the links below to learn more:

Blue Cross and Blue Shield of North Carolina 

Colorectal Screening for Medicare Beneficiaries