Reimbursement

Healthcare Professionals
Reimbursement

Medicare Coverage ⁽²⁾

Medicare recipients now have more choices for screening tests.

Covered Tests include:

Stool blood test (FOBT or Fecal Immunoassay Test) each year for those 50 and over

Flexible sigmoidoscopy (flex-sig) every 4 years for those 50 and over at average risk

Colonoscopy every 2 years for those at high risk

Colonoscopy once every 10 years for those 50 and over at average risk

Barium enema with air contrast instead if a doctor believes that it is as good as or better than flex-sig or colonoscopy.

What would someone on Medicare expect to pay for these tests?

Stool blood test Immunoassay or Guaiac: people over 50 pay no coinsurance and no Part B deductible

Flex-sig: Patient pays 20% of Medicare-approved amount after the yearly Part B deductible

Colonoscopy: Patient pays 20% of Medicare-approved amount after the yearly Part B deductible

Barium enema: When used instead of flex-sig or colonoscopy, patient pays 20% of Medicare-approved amount after the yearly Part B deductible