National Coverage Determinations
The Centers for Medicare & Medicaid Services (CMS) may make changes to Medicare-covered services. Changes are posted regularly at the National Coverage Determination site.
NCD 210.3: Effective Date January 1, 2023 -- Colorectal Screenings
CMS reduced the minimum age for coverage for the following Colorectal screening tests from 50 years to 45 years of age or older:
- Screening Flexible Sigmoidoscopy Test
- Screening Guaiac-based Fecal Occult Blood Test (gFOBT)
- Screening Immunoassay-based Fecal Occult Blood Test (iFOBT)
- Screening The Cologuard™ – Multi-target Stool DNA (sDNA) Test
- Screening Barium Enema Test
- Screening Blood-based Biomarker Tests
If you receive a positive result from a non-invasive stool-based CRC screening, Medicare will cover a follow-up screening colonoscopy with no cost share. Screening colonoscopies continue to not have a minimum age limitation. Patient cost doesn’t apply to either the non-invasive, stool-based test or the follow-on screening colonoscopy because both are specified preventive screening services.
To learn more and get the latest information, go to the National Coverage Determination site.
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