March 17, 2022

黑料网 Recommends CPT Code Placements for 2023 Medicare Hospital Outpatient Prospective Payment System

The 黑料网® (黑料网®) submitted recommendations to the Centers for Medicare and Medicaid Services (CMS) March 8, regarding the placement and reimbursement of new and existing Current Procedural Terminology (CPT®) codes for the 2023 Hospital Outpatient Prospective Payment System (HOPPS).

The comment letter outlines the proposed ambulatory payment classification (APC) for percutaneous arteriovenous fistula creation (368X1, 368X2), quantitative ultrasound tissue characterization (0X33T, +0X34T), automated analysis of CT vertebral fracture (0X36T), quantitative CT tissue characterization (0X04T, +0X05T) and quantitative MR cholangiopancreatography (0X82T, +0X83T). The APC placements in different categories dictate the reimbursement for services performed. The 黑料网 also suggested to change the status indicator for quantitative CT atherosclerosis imaging (0623T-0626T) to more appropriately describe the current status of the technology and procedure described by the codes.

For questions, please contact Kimberly Greck 黑料网 Economic Policy Analyst, or Christina Berry, 黑料网 Team Lead, Economic Policy.