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US · guidance

CMS Pub. 100-04, ch. 7, § 80.6

Colorectal Cancer Screening

activein force · 2026-08-25 – presentas-observed

See the Medicare Benefit Policy Manual, Chapter 15, "Covered Medical and Other

Health Services," §80.5, for coverage of colorectal rectal screening services.

Effective for services furnished on or after January 1, 1998, payment may be made for

colorectal cancer screening for the early detection of cancer. For screening colonoscopy

services (one of the types of services included in this benefit) prior to July 2001, coverage

was limited to high-risk individuals. For services July 1, 2001, and later, screening

colonoscopies are covered for individuals not at high risk. Screening colonoscopies are

not payable to the SNF. Screening colonoscopies are only covered when rendered in a

hospital or CAH.

For all other colorectal screening services payment is made under the MPFS or the

clinical diagnostic laboratory fee schedule based on the service rendered.

History

(Rev. 1, 10-01-03)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
73bb8f6983646d1e6cf8e1372642798c82c3e072729072d67933a4230e6d08f4
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