On December 2 the Centers for Medicare and Medicaid Services (CMS) released the calendar year 2021 Hospital Outpatient Prospective Payment System (HOPPS) final rule. Key provisions affecting otolaryngologist-head and neck surgeons include: facility payment for the new eustachian tube balloon dilation (ETBD) codes, prior authorization, changes to the ambulatory surgical center covered procedure list, and the elimination of the inpatient only list. Following advocacy efforts and input from the AAO-HNS, CMS has revised its Ambulatory Payment Classification (APC) placement of the new ETBD procedures. The placement of the new ETBD codes (CPT 69705 and 69706) in APC 5165 will help ensure patient access to these procedures. Finalized changes in the HOPPS rule take effect on January 1, 2021.
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