Non-Application of Deductible for Colorectal Cancer Screening Tests Provider Types Affected Physicians and providers who provide colorectal cancer screening services to Medicare beneficiaries Impact on Providers Effective January 1, 2007, Medicare will waive the annual Medicare Part B deductible for colorectal cancer screening tests billed with the HCPCS codes listed in the following chart. While the deductible will be waived, and will not apply for colorectal cancer screening test services furnished on or after January 1, 2007, the Medicare Part B coinsurance still applies for these screening tests.
Currently (prior to January 1, 2007, for colorectal cancer screening test services furnished before January 1, 2007), the annual Medicare Part B deductible AND coinsurance apply to the above codes. Please note that the annual Medicare Part B deductible and coinsurance do not apply for the following tests.
Background This policy is directed by Section 5113 of the Deficit Reduction Act (DRA) of 2005. It amends Section 1833(b) of the Social Security Act (SSA) by eliminating the requirement of the annual Part B deductible for colorectal cancer screening tests furnished on or after January 1, 2007. Additional Information SE0613 “Colorectal Cancer: Preventable, Treatable, and Beatable: Medicare Coverage and Billing for Colorectal Cancer Screening” contains pertinent information. It can be found at http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0613.pdf The manual attachment to CR5127 (Medicare Claims Processing Manual, Chapter 18, “Preventive and Screening Services,” Section 60.1 “Colorectal Cancer Screening; Payment”) contains additional information about colorectal cancer screening. CR 5127 is the official instruction issued to your Medicare carrier or fiscal intermediary (FI) regarding changes mentioned in this article. CR 5127 may be found at http://www.cms.hhs.gov/Transmittals/downloads/R1004CP.pdf If you have questions, please contact your Medicare carrier or FI at their toll-free number, which may be found at http://www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip Disclaimer Attention Physicians! MLN Matters Number: MM5127 |
on the Centers for Medicare & Medicaid Services (CMS) Web site. This special edition also includes links to other resources related to colorectal cancer screening and Medicare-covered preventive services.
on the CMS Web site.
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