CMS has released the 2016 Medicare Physician Fee Schedule proposed rule, which includes cuts for colonoscopy and other lower GI/endoscopy procedures, according to the American Gastroenterological Association.
Here are four key points on how the proposed rule would affect GI.
1. The reimbursement cuts for the colonoscopy family procedures could be up to 19 percent.
2. The AGA and its sister GI societies are unable to estimate the full impact of the cuts yet, due to errors in data files posted by CMS.
3. Proposed changes for 11 lower GI/endoscopy procedures, by RVU percent change, include:
• Colonoscopy with biopsy (45380): -19 percent
• Colonoscopy with snare polypectomy (45385): -12 percent
• Colonoscopy (45378): -11 percent
• Colorectal cancer screen, high risk (G0105): -2 percent
• Colorectal cancer screen, low risk (G0121): -2 percen
• Colonoscopy with hot biopsy (45384): -11 percent
• Colonoscopy with submucosal injection (45381): -14 percent
• Colonoscopy, flexible with ablation (45388): -15 percent
• Flexible sigmoidoscopy with biopsy (45331): -7 percent
• Flexible sigmoidoscopy (45330): -20 percent
• Colonoscopy with control of bleeding (45382): -16 percent
4. The AGA, American College of Gastroenterology and American Society of Gastrointestinal Endoscopy are working to combat these proposed cuts.
Click here to view the full proposed Physician Fee Schedule rule.