CMS announced today that it is expanding Medicare coverage of bariatric surgery. Prior to today’s decision, CMS’s only nationally-covered bariatric surgery procedure was gastric bypass surgery. Effective today, the list of nationally-covered procedures now includes open and laparoscopic Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding, and open and laparoscopic biliopancreatic diversion with duodenal switch. But Medicare will not cover bariatric surgery in patients who only have the diagnosis of obesity. Patients must also have an obesity-related disorder, such as hypertension, type 2 diabetes, coronary heart disease, stroke, gall bladder disease, osteoarthritis, sleep apnea, respiratory problems, and certain types of cancers. In addition, CMS will cover bariatric surgery done in centers of excellence certified by the American College of Surgeons and the American Society for Bariatric Surgery.
