The payment landscape for gastroenterology is changing. Here are four recent updates on reimbursement for gastroenterologists to know.
1. Colonoscopy payment cuts. Despite lobbying done by the three sister GI societies, CMS finalized cuts to colonoscopy reimbursement with the release of the CY 2016 Physician Fee Schedule Final Rule in Nov. 2015. The reimbursement cuts for some procedures are more than 17 percent.
2. MPFS emergency updates. CMS released an emergency update to its 2016 Medicare Physician Fee Schedule, which addresses technical errors in the MPFS update files. The changes will be retroactive to Jan. 1. The updates affect a number of GI/endoscopy office payments.
3. PQRS deadline extension. The original deadline to submit 2015 data for the CMS Physician Quality Reporting System was Feb. 26, but CMS extended the deadline is March 18. Physicians who fail to report data by the deadline will be subject to a 2 percent downward adjustment in Medicare reimbursement in 2017.
4. CMS and virtual colonoscopy. Senators James Inhofe (R-Okla.) and Bill Nelson (D-Fla.) introduced a bill that would require CMS to cover computed tomography colonography as a colorectal cancer screening modality. The United States Preventative Services Task Force lists virtual colonoscopy as an alternative screening modality, but does not actually recommend the test. CMS typically references USPSTF guidelines when making coverage determinations.