On October 31, the Centers for Medicare and Medicaid Services (CMS) finalized a new Medicare policy that will cut 2.5 percent from the vast majority of physician services. The payment reduction, being levied against the work values of all non-time-based services, is being characterized as an ‘efficiency adjustment’ by CMS and would cut endoscopy services by 2.4 to 2.7 percent. The cuts to endoscopy are made significantly worse by changes to how the indirect practice expense cost component is calculated for professional fees when services are provided in a facility. 

The physician specialty and surgical community have launched a large-scale lobbying and grassroots advocacy effort to convince Congress to delay implementation of the arbitrary efficiency adjustment, and we need your help. 

Make no mistake, as a high-volume, procedure-based specialty, endoscopy is a target. Policymakers—and even some primary care organizations—continue to assert that endoscopy is overvalued and are taking direct aim at gastroenterology. A fact sheet now circulating on Capitol Hill from the American Academy of Family Physicians notes that colonoscopy has not been “revalued” in more than a decade and highlights that office-based colonoscopy (45378) will increase by $40 next year, implying that GI is benefiting from current CMS proposals.

What the fact sheet does not acknowledge is that during the last comprehensive revaluation of the endoscopy family of codes, the average reduction was roughly 12 percent. Nor does it note that the cited increase to office-based colonoscopy is essentially a red herring; the overwhelming majority of colonoscopy and other endoscopy services are performed in hospital outpatient departments and ambulatory surgery centers, where payments are slated to decrease. Taken together, this paints a misleading picture of “windfall” gains for endoscopy while ignoring the significant cuts the specialty has already sustained and is being asked to absorb again.

We need you to help us set the record straight with Congress. ASGE is urging you to contact your members of Congress today. Tell them the truth of how endoscopy and your patients will be impacted by CMS’ ill-conceived policy and ask them to delay implementation of the efficiency adjustment until there can be a thoughtful examination of how and to which services it is applied. 

Take action now.