ACR Heralds Centers for Medicare and Medicaid Services Move to Cover Screening CT Colonography for Seniors

After many years of advocacy by the American College of Radiology® (ACR®), the Centers for Medicare and Medicaid Services (CMS) proposed coverage of CT colonography (CTC) for colorectal cancer (CRC) screening of Medicare patients in its 2025 Hospital Outpatient Prospective Payment System proposed rule and its 2025 Medicare Physician Fee Schedule proposed rule. ACR applauds this proposal as a big step forward toward providing Medicare patients access to a minimally invasive CRC screening tool that can detect pre-cancerous polyps and does not require anesthesia.

In the United States, colorectal cancer is the leading cancer killer in men under 50 and the second leading cause of cancer death in women under 50. African Americans are about 20% more likely to get colorectal cancer and about 40% more likely to die from it than most other groups, according to the American Cancer Society (ACS). Even more alarming, an estimated 106,590 new cases of colon cancer (54,210 in men and 52,380 in women) will be diagnosed in 2024.

Recent census data shows that more Black and Hispanic people are getting screened with CTC compared to whites. Studies at the University of Wisconsin, U.S. military medical centers and in Europe show that use of the virtual exam significantly boosts screening rates and lowers costs, which can allow more providers to offer screening and save more lives.

The College began to push CMS for CTC coverage with publication of the American College of Radiology Imaging Network National CT Colonography Trial in 2008. ACS, the U.S. Preventive Services Task Force and the U.S. Food and Drug Administration all recognize and support coverage. However, CMS denied coverage in 2009 and continued to deny several reconsideration requests until now.

Most recently, members of the ACR Colon Cancer Committee met with Dora Hughes, MD, MPH, Acting Chief Medical Officer and Acting Director of the Center for Clinical Standards and Quality for CMS and Coverage and Analysis Group officials regarding Medicare coverage of CTC for CRC screening in May.

For more information, contact Katie Keysor, ACR Senior Director of Economic Policy.