State of Alabama
09/17/2025 | Press release | Distributed by Public on 09/17/2025 11:26
Noninvasive Colorectal Cancer (CRC) Screening
TO: Physicians, Independent Laboratories, Independent Radiology, Hospitals, Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)
RE: Noninvasive Colorectal Cancer (CRC) Screening
Effective October 1, 2025, the Alabama Medicaid Agency (Medicaid) added coverage for the following noninvasive colorectal cancer (CRC) screening: CT colonography and Cologuard. Medicaid will cover these codes in accordance with the United States Preventative Services Taskforce (USPSTF) recommendation.
CT Colonography (HCPCS Code 74263)
Medicaid will cover CT colonography when ordered by a treating physician and for patients who meet these criteria:
· Age 45 to 75
· Asymptomatic
· Limited to once every 5-year
Cologard (HCPCS Code 81528)
Medicaid will cover the Cologuard test when ordered by a treating physician and for patients who meet these criteria:
· Age 45 to 75
· Asymptomatic
· Limited to once every 3-year
Providers with billing questions may contact the Gainwell Technologies Provider Assistance Center at 1-800-688-7989.
The Current Procedural Terminology (CPT) and Current Dental Terminology (CDT) codes descriptors, and other data are copyright © 20 25 American Medical Association
and © 20 25 American Dental Association (or such other date publication of CPT and CDT). All rights reserved. Applicable FARS/DFARS apply.
State of Alabama published this content on September 17, 2025, and is solely responsible for the information contained herein. Distributed via Public Technologies (PUBT), unedited and unaltered, on September 17, 2025 at 17:26 UTC. If you believe the information included in the content is inaccurate or outdated and requires editing or removal, please contact us at [email protected]