Medicare Coverage of Anesthesia Services During Screening Colonoscopies for Patients at Low Risk of Sedation-Related Complications

In 2014, the Centers for Medicare & Medicaid Services waived patient cost sharing for anesthesia services during screening colonoscopies. The current professional guidelines recommend that sedation be provided by the gastroenterologist-nurse team; a separate anesthesiologist or nurse-anesthetist should be involved and paid separately only for patients with an increased risk of sedation-related complications. The stated rationale is that the provision of anesthesia has become standard practice for colonoscopies and that eliminating cost sharing may increase the rates of these examinations. We examined the costs and potential benefit of the Medicare rule change.