AMA CPT and RUC Processes
AMA CPT Editorial Review Process
Did you ever wonder how CPT codes are created and how the code set is maintained? View this section of the AMA website that provides a brief overview and history of CPT, the process of code request submission and review, and the roles that the Panel and Advisory Committee groups have in the process.
Background on the CPT Process
Click here to review a brief, easy-to-understand overview of the AMA CPT process to add, delete, or revise a CPT code, the AMA CPT Editorial Panel’s process for reviewing CCPs along with literature and other requirements, as well as AAO-HNS involvement in the process.
AMA RUC Process – Obtaining RVUs for CPT codes
Immediately following the CPT Editorial Panel’s acceptance of the code change proposal (CCP) request, the RUC process begins. All participating specialties have an opportunity to indicate a “level of interest” from which indicates their interest in developing relative value recommendations for the new code(s).
Background on the RUC Process
The AMA RUC has developed a slide set to explain the RUC process. Click here to access the slide set (login required).
For a one-pager on the vital role YOU play in determining your reimbursement, view this AAO-HNS educational flyer on RUC surveys.
CMS Final Approval
The AMA RUC makes recommendations on the Relative Value Units (RVUs) of new and revised physician services to the Centers for Medicare and Medicaid Services (CMS). CMS reviews the recommendations and determines whether or not to accept them, publishing final values in the Medicare Physician Fee Schedule.
AAO-HNS Involvement in the AMA CPT and RUC Processes
AAO-HNS members are represented at the AMA/Specialty Society RUC and AMA CPT Editorial Panel meetings by the AAO-HNS Physician Payment Policy (3P) Workgroup’s RUC and CPT team members. The RUC and CPT teams work with AAO-HNS committees, sub-specialty societies, other medical specialties and stakeholders, to represent members’ best interests by advocating for pertinent new codes; skillfully navigating each meeting to ensure proper valuation of new and established codes; and assisting with the review of existing codes.
