Expanding the Fight for Medicare CT Colonography Coverage

Dr. YEEThe following post was contributed by Judy Yee, Md, FACR, chair of the ACR colon Cancer Committee.

A recent study showing a significant rise in younger people developing colorectal cancer (CRC) indicates that we must take a fresh look at who should be screened and how to attract them to do so. This, along with the fact that more than a third of those 50 and older are not getting tested, reinforce that more screening exams must be covered by private insurance and Medicare.

Particularly, we need covered access to less-invasive, patient-centered options like virtual colonoscopy (CT colonography or CTC) if we are to attract more people to be screened and save more lives.

CTC is gaining more acceptance. U.S. Preventive Services Task Force (USPSTF) screening 2016 recommendations assigned an “A” grade to a list of screening tests—including­ CTC. Under the Affordable Care Act, this “A” grade triggered a federal mandate that private insurers cover CTC (and the other USPSTF-recognized tests) with no co-pay. The Centers for Disease Control and Prevention (CDC) campaign “Screen for Life” also supports the USPSTF recommendation and lists CTC as a recommended exam.

What remains elusive is Medicare coverage for CTC. An expanding group of medical societies and patient advocates, including the American College of Radiology, the American Gastroenterological Association, the National Hispanic Medical Association, Colon Cancer Alliance and others continue to work to gain this Medicare coverage and to ensure continued private insurer coverage of these exams. These groups back the CT Colonography Screening for Colorectal Cancer Act (H.R. 1298), which would mandate Medicare CTC coverage.

To inform your privately insured patients that they now have the option of getting a CT colonography, please visit ACR.org/VirtualCT. There, you can download and display materials (available in English and Spanish) to educate patients regarding what CT colonography is, how it works and how to prepare for screening.

I also urge you to send patients who may have questions about these lifesaving exams to RadiologyInfo.org/VirtualCT.

Be sure to follow ACR on Facebook, Twitter, Instagram and LinkedIn and share or like posts, which use the hashtag #virtualCT (virtual colonoscopy).

Please share your thoughts in the comments section below and/or join the discussion on Engage (login required).


One thought on “Expanding the Fight for Medicare CT Colonography Coverage

  1. My Dr. has ordered me to have a Virtual Colonoscopy as he was unable to do complete the regular colonoscopy due to Diverticulosis. Medicare will not cover this procedure. Any ideas?

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