CMS reduces Colonoscopy Reimbursement in 2018

The 2018 Medicare Physician Fee Schedule reduces the base unit value for screening colonoscopy from 5 to 3, this represents a 40% reduction in base units for the procedures that translates into an estimated 28% reduction in reimbursement, based on an average of 7.2 units billed.  CPT codes 00740 (anesthesia for upper GI procedures) and 00810 (anesthesia for lower GI procedures) have been replaced with a series of five new codes to distinguish different types of procedures.  We will be calculating the anticipated financial impact associated with the changes for each of our clients and communicating this for budgeting and planning purposes.