Medicare to cover colorectal cancer screenings ordered by PAs, APRNs

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Physician assistants and advanced practice registered nurses can now order every noninvasive colorectal cancer screening test Medicare covers, ending a long-standing physician-only requirement under a CMS coverage change.

CMS authorized the expanded coverage in June when it finalized a decision memo revising the “Screening for Colorectal Cancer — Non-Invasive Biomarker Tests” national coverage determination, the American Academy of Physician Associates said in a Sept. 10 news release.

The determination previously covered the tests only when a physician ordered them. CMS reopened it after new evidence emerged on stool-based RNA tests.

PAs and APRNs may now order RNA-based stool tests, DNA-based stool tests, DNA-based blood tests and fecal occult blood tests.

“While colon cancer is the second leading cause of cancer death in the United States, it has a high survival rate if detected early,” Sondra DePalma, PA-C, the AAPA’s vice president of reimbursement and professional practice, said in the release. “As a result of these policy changes, patients treated by PAs will be able to obtain authorization for these tests in a more timely manner.”

The coverage decision lands amid a broader push to expand what PAs and APRNs can do independently as health systems lean on them to widen access.

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