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Deven Stopa
May 17, 2022

As the number of advanced stage colorectal cancer patients continue to rise, GI physicians are looking to continue to provide care despite raised costs

As the number of advanced stage colorectal cancer cases rises in the U.S., physicians are working to find ways to continue to serve the needs patients while remaining profitable. They are effectively having to find a way to combat costs for CRC screenings.

Reimbursement for CRC Screenings

According to Becker’s, the largest challenge comes in declining reimbursements for colonoscopies for Medicare and Medicaid patients provided by The Centers for Medicare and Medicaid Services (CMS). In the United States, colorectal cancer is the second largest cause of cancer-related death between men and women combined.

With updates to screening guidelines released by the United States Preventative Services Task Force (USPSTF) reducing the minimum age to 45, a new generation of patients now have access to this vital procedure.

“CMS needs to realize that early endoscopy is valuable in preventing downstream morbidity to the patient and downstream cost to the overall healthcare system if diagnoses are made at later stages,” Omar Khokhar, MD, a gastroenterologist in Bloomington, Ill., told Becker’s.

Despite the decrease in reimbursements, physicians are continuing to provide necessary screenings to patients. These include colonoscopies, also commonly referred to as the “gold standard” in colorectal cancer screening procedures.


However, a positive note in the story remains the cost-saving abilities of physician-owned ASCs. This is in comparison to care at a hospital outpatient department (HOPD). This trend has become more pronounced over recent years, as more patients are looking toward local ASCs for care.

A Feb. 8 article from Carly Behm on Becker’s showed the large disparity in patient costs for colonoscopies. According to the article, the total cost of a colonoscopy at an ASC totalled $728, with patients paying $144. In comparison, the same procedure at an HOPD saw costs totalling $1,240, with patients paying $247.

The reduced cost will likely bring more patients. Therefore, this brings more revenue into ASCs, helping recoup losses brought about by CMS reductions.