ACR Urges CMS to Update Colorectal Cancer Screening Tests NCD

ACR® has formally asked CMS to update the National Coverage Determination (NCD) 210.3 – Colorectal Cancer Screening Tests to reflect the fact that Medicare now covers screening computed tomographic colonography (CTC).

Following a multi-year ACR public, provider and decisionmaker education and advocacy campaign regarding CTC efficacy, cost efficiency, and patient compliance gains, CMS announced in the 2025 Hospital Outpatient Prospective Payment System (OPPS) and 2025 Medicare Physician Fee Schedule (PFS) final rules that it will cover beneficiaries for CTC. CMS has since issued coverage transmittals to providers but has yet to update the official colorectal cancer NCD.

In a Sept. 25 letter to CMS, ACR highlighted that: although CMS has directed Medicare Administrative Contractors to begin covering CPT® code 74263 for screening CTC starting Jan. 1, 2025, the NCD still lists CTC as a non-covered service. This discrepancy creates confusion for providers and Medicare beneficiaries.

To resolve this issue, ACR urges CMS to:

1. Update NCD 210.3 to reflect expanded coverage for CTC.
2. Retire or remove CAG-00396N, the original non-coverage decision for CTC, to eliminate ongoing confusion.

These updates are critical to ensuring clarity, consistency and access to colorectal cancer screening options for Medicare beneficiaries.

For questions or more information, contact Alicia Blakey, ACR Principal Economic Policy Analyst.