Medicare 2023 Proposed Payment Policies Released

On July 7, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2023 Medicare Physician Fee Schedule (MPFS) Proposed Rule. The rule will be posted in the Federal Register no later than July 11.

Good News!

In a win for patients and thanks to our collective advocacy efforts, 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. The GI societies will continue to work with a coalition of national and state medical societies in urging Congress to prevent these cuts before January 1, 2023.

More Details: 

  • CMS expands CRC 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 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.

To find out more about how these provisions will impact GI, read the GI societies’ summary.

CY 2023 Medicare Proposed Physician Payment Chart

CMS Proposed Rules and Fact Sheets


About Gastrointestinal Endoscopy
Gastrointestinal endoscopic procedures allow the gastroenterologist to visually inspect the upper gastrointestinal tract (esophagus, stomach and duodenum) and the lower bowel (colon and rectum) through an endoscope, a thin, flexible device with a lighted end and a powerful lens system. Endoscopy has been a major advance in the treatment of gastrointestinal diseases. For example, the use of endoscopes allows the detection of ulcers, cancers, polyps and sites of internal bleeding. Through endoscopy, tissue samples (biopsies) may be obtained, areas of blockage can be opened and active bleeding can be stopped. Polyps in the colon can be removed, which has been shown to prevent colon cancer.

About the American Society for Gastrointestinal Endoscopy
Since its founding in 1941, the American Society for Gastrointestinal Endoscopy (ASGE) has been dedicated to advancing patient care and digestive health by promoting excellence and innovation in gastrointestinal endoscopy. ASGE, with almost 16,000 members worldwide, promotes the highest standards for endoscopic training and practice, fosters endoscopic research, recognizes distinguished contributions to endoscopy, and is the foremost resource for endoscopic education. Visit Asge.org and ValueOfColonoscopy.org for more information and to find a qualified doctor in your area.

 

American Society for Gastrointestinal Endoscopy
3300 Woodcreek Drive Downers Grove, IL 60515
P (630) 573-0600
F (630) 963-8332

Media Contact

Andrea Lee
Director of Marketing and Communications
630.570.5603
ALee@asge.org