When it comes to valuing CPT codes, the 3P group serves as the expert consensus panel to analyze surveys completed by Academy members and make recommendations for appropriate Relative Value Units (RVUs) to the AMA/Specialty Society Relative Value Update Committee (RUC) for otolaryngology-related codes. Some of these members also represent the Academy at the RUC meetings. The RUC makes recommendations on the Relative Value Units (RVUs) of new and revised physician services to the Centers for Medicare and Medicaid Services (CMS). The RUC also performs broad reviews of the Resource Based Relative Value System every five years and rolling reviews of many codes based on screens such as high utilization, frequency of codes used together, and codes not surveyed since the beginning of the RUC process over twenty years ago.
To provide a more streamlined process, consistent with approaches adopted by other specialty societies, 3P initiated development of the New Technology Pathway, a process approved by the Board in September, 2010 that the Academy has adopted and now requires for any requests for guidance on how to code for a new technology, new CPT codes for services or procedures, or revisions or revaluations of existing codes. The newly formalized process includes coordination between 3P and experts from other applicable AAO-HNS Committees (i.e., Medical Device and Drug Committee, CPT/RVU Committee, etc.) as a way to incorporate all of the resources of the Academy in the interest of the members. We are confident that the New Technology Pathway will address such requests in a manner which is clearly defined, consistent with AMA CPT and RUC guidelines, accounts for the interests and perspectives of all stakeholders while protecting against undue influence of any group or individual, encourages the collection of reliable data, and promotes efficient, fair reimbursement for our members and appropriate access to new procedures and services for our patients.
The New Technology Pathway starts by completing the "New Technology Application: Request for CPT/RBRVS Assistance", an internal Academy document.
For the AAO-HNS statement on new technology and information about communication procedures and lobbying policies, please see the “AAO-HNS New Technology Pathway Requests Policies and Procedures” document above.
Inquiring parties, including physicians and industry representatives, should send the completed package to the Academy's Health Policy team.