Update: Colorectal Cancer Screening Coverage

The United States Preventive Services Taskforce (USPSTF) has revised the colorectal cancer screening guideline, dropping the eligible screening age from 50 years old to 45 years old to allow for earlier screenings of younger populations with a required effective date of June 1, 2022.

This change, covering colorectal cancer screenings and associated services at 100% for eligible members aged 45 and older, will be fully implemented according to the dates listed below.

• Effective March 7, 2022, for members of fully-insured commercial (individual and group) plans
• Effective April 1, 2022, for members of self-funded group health plans, including State Health Plan members

Providers can also check the effective date of this change at the member level by calling our Provider Blue Line SM at 800-214-4844.

For full details on current claims submission, please see the Health Care Reform Preventive Services Coding Guide (PDF). The Coding Guide has been revised to reflect this change.