Currently Medicare does not provide coverage of CT colonoscopy—often referred to as virtual colonoscopy—except under very limited circumstances through local coverage decisions. In May, 2008, however, CMS announced that it was opening a national coverage evaluation on whether it should provide nationwide coverage.
In announcing the review, CMS said that, in March, 2008, the American Cancer Society, American College of Radiology, and the US MultiSociety Task Force on Colorectal Cancer issued cancer screening guidelines that included CT colonoscopy as an acceptable option for screening. Currently, CMS covers use of fecal occult blood testing, sigmoidoscopy, optical colonoscopy, and barium enema for colorectal cancer screening in average risk adults age 50 and older—but not CT colonoscopy.
In seeking public comment, Medicare said it was particularly interested in clinical studies and other scientific information related to the technology—especially the type of studies needed if it determines that the evidence is inadequate for coverage.
Click to view the CMS tracking sheet.
Click to view a state-by-state summary of local Medicare coverage policies on virtual colonoscopy (as well as those by commercial payers).