ASGE, ACG, AGA oppose cuts to colonoscopy reimbursement rates proposed by CMS

The American Society for Gastrointestinal Endoscopy, the American College of Gastroenterology and the American Gastroenterological Association have issued a joint statement opposing significant cuts to reimbursement rates for colonoscopy and other lower GI endoscopic procedures proposed by the Centers for Medicare and Medicaid Services on July 8.

The 2016 Medicare Physician Fee Schedule proposed rule would cut physician work values for the colonoscopy family up to 19%, according to the joint statement. “Cuts of this magnitude could compromise the nation’s public health efforts to reduce colorectal cancer,” according to the release.

The proposed rates for the colonoscopy code family “are not data-driven,” the societies stated in the release, and the methods by which physicians work and intensity for such procedures are “severely flawed.”

The societies will meet with CMS leadership this month to explore “every means to mitigate these cuts before they are finalized.” Furthermore, they will review rules proposed by the Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective System/Ambulatory Surgical Center Payment System.

The deadline for comments on the MPFS proposed rule is September 8; the rates will be finalized in November and take effect January 1, 2016, according to the statement.

Reference:

The Value of Colonoscopy Website. CMS proposes cuts to 2016 colonoscopy rates. Available at: http://valueofcolonoscopy.org/proposedrule/. Accessed July 10, 2015.