Medicare Coverage for Colorectal Cancer Screenings Expanded to Include All PA-ordered Tests

September 10, 2026

PAs and APRNs may now order all non-invasive colorectal cancer screening tests covered by Medicare, including RNA-based stool tests, DNA-based stool tests, DNA-based blood tests, and fecal occult blood tests (FOBT). CMS authorized this expanded coverage in June 2026 when it finalized a decision memo revising the “Screening for Colorectal Cancer—Non-Invasive Biomarker Tests” National Coverage Determination (NCD). 

Previously, the Medicare NCD only covered diagnostic tests when ordered by a physician. CMS reopened the NCD through a “decision memo” when new evidence was presented regarding stool-based RNA tests.  

In the decision memo, CMS proposed to authorize PAs and APRNs to order certain DNA and RNA screening tests but did not include FOBT. Prior to the authorization made by CMS, AAPA advocated for these policy changes on several occasions, including through responses to requests for information on opportunities for deregulation, a formal comment letter in response to CMS’s decision memo pertaining to the NCD, and a direct meeting between AAPA’s Reimbursement and Professional Advocacy Team and the NCD team at CMS.  

AAPA’s direct advocacy led CMS to include PA and APRN-ordered FOBT among the authorized tests prior to publication of the final NCD decision memo.  

“This policy change demonstrates that CMS is willing to remove barriers to PA practice, but, most importantly, it will give Medicare beneficiaries expanded access to regular screenings that are essential for early detection of colon cancer,” AAPA Vice President of Reimbursement and Professional Practice Sondra M. DePalma, DHSc, PA-C, DFAAPA, said.  

“While colon cancer is the second leading cause of cancer death in the United States, it has a high survival rate if detected early. 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 expanded authorization will also reduce provider administrative burden and reduce waste if a patient does not need to schedule an additional visit with a physician to obtain an order the treating PA is able to provide. 

For more information on this expanded authorization, please review the final NCD decision memo. For more information regarding AAPA’s advocacy efforts, please review our comments to the NCD decision memo. For any further questions regarding the NCD or AAPA’s comments, please contact [email protected]. 

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