News from the AGA

Understanding proposed changes to Medicare payment policies


 

On July 7, the Centers for Medicare & Medicaid Services released the calendar year (CY) 2023 Medicare Physician Fee Schedule Proposed Rule and can now be found in the Federal Register.

Good news!

In a win for patients, and thanks to collective advocacy efforts from AGA and partner societies, CMS is proposing to expand the regulatory definition of “colorectal cancer screening tests” and waive cost sharing for a necessary follow-up colonoscopy after a positive stool-based screening test.

Looming cuts

The rule proposes 4% cuts to Medicare physician reimbursement through required decreases in the conversion factor and expiration of temporary fixes passed by Congress. AGA will continue to work with a coalition of national and state medical societies in urging Congress to prevent these cuts before Jan. 1, 2023.

What to know

  • CMS expands colorectal cancer screening in a proposal to waive cost sharing for a follow-up colonoscopy to a positive stool-based colorectal cancer screening test and to cover the service for individuals 45 years of age and above.
  • Medicare payment cuts are looming with cuts to the proposed CY 2023 conversion factor.
  • Split/shared visits policy delayed until CY 2024.
  • Payment rates for new bariatric device codes proposed.

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