CMS denies reimbursement for CT colonography screening

The Centers for Medicare and Medicaid Services has proposed that payment for CT colonography be declined, saying there is not enough evidence to support it as a colorectal cancer screening tool.

In a Proposed Decision Memorandum issued Feb. 11, CMS suggests that existing scientific evidence is inadequate to conclude that CTC improves net health benefits for asymptomatic, average risk Medicare beneficiaries. CMS thus decided that CTC for colorectal cancer screening should remain uncovered.

"While it is a promising technology, many questions on the use of CT colonography need to be answered with well-designed clinical studies that focus on health outcomes for the Medicare population. Until the evidence is sufficient, CMS strongly encourages physicians and beneficiaries to participate in colorectal cancer screening by selecting one of the several CRC screening tests that are currently covered under Medicare," CMS said in its memo.

CMS requested public feedback on the proposed determination and announced it will issue a final decision after considering comments. In its statement, however, CMS cautioned that even if it finds that CTC is clinically effective, additional information and public comments would be needed to determine the test cost effectiveness.