CMS proposes expanded coverage for non-invasive colorectal cancer tests for Medicare beneficiaries
CMS's proposed decision memo suggests covering non-invasive biomarker tests for average-risk Medicare beneficiaries, contingent on meeting specific accuracy and regulatory standards, with public comments invited.
The Centers for Medicare & Medicaid Services (CMS) has proposed changes to colorectal cancer screening test coverage for certain Medicare beneficiaries, according to a proposed decision memo.
If accepted, the changes would be made to NCD (210.3). CMS is suggesting that non-invasive biomarker colorectal cancer screening tests should be covered for the following Medicare beneficiaries aged 45-85 triennially:
Those who are not experiencing symptoms.
Those whose test was ordered by a physician, physician assistant, nurse practitioner, or clinical nurse specialist.
Those “at average risk of developing colorectal cancer.”
Additionally, according to CMS, the tests need to meet certain sensitivity, specificity, and regulatory requirements. The agency is requesting public comments regarding the changes.
