CMS Finalizes Policy to Waive Cost-Sharing for Colonoscopy After Positive At-Home Colorectal Cancer Screening Test

In a November 2 press release, CMS finalized a policy ruling that follow-up colonoscopies to a positive at-home screening test are considered a preventive service. This policy will eliminate cost-sharing for colon cancer screening for Medicare beneficiaries, thus reducing barriers to necessary services.

Colon and rectal cancers continue to be a leading cause of death in the United States with even higher new cases and death rates for Black Americans, American Indians, and Alaska Natives. Medicare will now reduce the minimum age for colorectal cancer screening from 50 to 45 years, in alignment with recently revised policy recommendations by the U.S. Preventive Services Task Force. Additionally, Medicare will now cover as a preventive service a follow-on screening colonoscopy after a non-invasive stool-based test returns a positive result, which means that beneficiaries will not have out-of-pocket costs for both tests.

CMS Press Release

This is an extremely important policy that could increase screening uptake, enhance equity and ultimately save lives, which are stated goals of the Cancer Moonshot. The removal of a cost barrier starting this spring could help hundreds of thousands more people avoid the dilemma of having to decide if they can afford to follow up on their initial positive colorectal screening test.