Cuts to 2016 Colonoscopy Rates Run Deep
The physician work values for the colonoscopy family are cut up to 17%.
Y
ou know that
the physician
cuts in
Medicare reimburse-
ment for
colonoscopy and
other lower GI
endoscopy proce-
dures are severe
when you hear
reports that gas-
troenterologists may
reduce colonoscopy
cases or even retire early because of them. But that's what we're fac-
ing this year. In the finalized CY 2016 Physician Fee Schedule rule,
CMS cut reimbursement for several colonoscopy codes.
Mitigating the cuts
The colonoscopy code family — the highest volume code family —
was hit hardest. Critics say the colonoscopy cuts are inappropriately
deep and, at their highest, slash 2016 physician payment for some pro-
cedures by more than 17%. Though CMS's ASC cuts pale in compari-
son to the decreases we're seeing in physician payments, the dramatic
reductions may also have a long-term impact on your colonoscopy
screening volume.
On the facility side, the colonoscopy family is facing a 2.7% cut from
last year, which averages out to be about $12 less per procedure. This
2 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J A N U A R Y 2 0 1 6
Coding & Billing
Stephanie Ellis, RN, CPC
• COST CUTTING Some of your most common procedures, including colonoscopies, will be reim-
bursed at a lower rate in 2016.
