The following process is required for a new technology or revised procedure to receive a Current Procedural Terminology (CPT) Code, receive a value, and establish a Medicare payment:
- The process begins with review of a Code Change Proposal (CCP) application by the AMA CPT Editorial Panel.
- After approval by the CPT Editorial Panel, the AAO-HNS is involved in surveying members and making recommendations for a relative value unit (RVU) at a presentation before the AMA/Specialty Society Relative Value Update Committee (RUC).
- CMS reviews the RUC recommendations and makes a final decision about the RVU, and a dollar amount is calculated.
As a part of supporting new technology, the Academy welcomes opportunities to address coding and reimbursement issues for Otolaryngology-related new or revised CPT or HCPCS codes. The New Technology Pathway was developed to provide a framework for transparent, ethical engagement between the Academy and industry representatives in a manner that encourages responsible decision making.