As rates of colorectal cancer, especially among young patients, rise in the U.S., reimbursement cuts to screening procedures may spell trouble for the industry.
Over the last 20 years, reimbursement rates for screening colonoscopies, when considering inflation, have dropped by nearly 50%. On top of that, gastroenterologists are feeling underpaid as salaries have struggled to keep up with rising inflation rates.
Benjamin Levy, MD, gastroenterologist and clinical associate of medicine at the University of Chicago Medicine, told Becker’s about his concerns for the future of colonoscopy care.
Dr. Levy: Like many gastroenterologists, I am concerned about the continued cuts to colonoscopy reimbursement rates. For 2025, CMS proposed a 2.83% reduction in the physician fee schedule conversion factor. According to a recent American Society for Gastrointestinal Endoscopy publication, reimbursement for colonoscopies (accounting for inflation) has already declined 49% since 1992.
It’s important for physicians to be reimbursed sufficiently to account for the amount of training (three year gastroenterology fellowship and three year internal medicine residency), skill, experience and time required to perform colonoscopy procedures. Colonoscopies are critical in our nation’s efforts to prevent colorectal cancer by trying to remove polyps before they turn into cancer. We also frequently diagnose colorectal cancer during screening colonoscopies.
Medicare currently pays gastroenterologists approximately $220 for a procedure that takes 30 minutes to an hour. With our new modern electronic medical record systems such as Epic that many hospitals and outpatient surgical centers have been adopting over the past few years, we also spend extra time reviewing pathology and communicating the results electronically with patients which takes another 10 to 15 minutes per patient. Colonoscopies are an important part of our effort to prevent colorectal cancer and save lives. It’s important for physicians to be reimbursed properly to prevent super experienced gastroenterologists from retiring early.
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