Prolonged Preventive Services:


Section 4104 of the Affordable Care Act defined the term “preventive services” to include
“colorectal cancer screening tests,” and as a result, it waives any coinsurance that would
otherwise apply under Section 1833(a)(1) of the Social Security Act (the Act) for screening
In addition, the Affordable Care Act amended Section 1833(b)(1) of the Act to waive the Part B
deductible for screening colonoscopies, which includes anesthesia services as an inherent part
of the screening colonoscopy procedural service. These provisions are effective for services
furnished on or after January 1, 2011.
In the Calendar Year (CY) 2018 Physician Fee Schedule (PFS) Final Rule, the Centers for
Medicare & Medicaid Services (CMS) modified reporting and payment for anesthesia services
furnished in conjunction with and in support of colorectal cancer screening services. .
Effective for claims with dates of service on or after January 1, 2018, prolonged preventive
services will be payable by Medicare when billed as an add-on to an applicable preventive
service that is payable from the Medicare Physician Fee Schedule, and both deductible and
coinsurance do not apply.G0513 and G0514 for prolonged preventive services will be added as
part of January1, 2018, HCPCS update and the coinsurance and deductible will be waived.