The American Medical Association (AMA) Relative Value Update Committee (RUC) and Current Procedural Terminology (CPT) meet three times a year to keep the CPT code set up to date and review resource costs for physicians. The two-step meetings of the CPT Editorial Panel and the RUC allow physicians to provide direct input to the Centers for Medicare & Medicaid Services (CMS), helping meet the changing needs of medicine and speeding up the inclusion of updated medical techniques in the CPT code set.
The ACR has five volunteer advisors who actively participate in the AMA’s CPT Editorial Panel and RUC processes to ensure CPT codes appropriate for rheumatologic services and procedures are developed and the appropriate values are placed on the codes. The advisors to the CPT Editorial Panel and the RUC frequently work with advisors from other specialty societies to develop and present new and revised CPT code proposals and recommended code values. Below is a guide on the CPT and RUC processes, as well as the ACR’s recent activities in this area.
The CPT Editorial Panel maintains the CPT code set and meets regularly to review proposals for new and revised codes, while the RUC makes recommendations to the CMS on relative values assigned to all new and revised CPT codes.
Once codes are vetted and voted on at the CPT Editorial Panel, specialty societies then survey their members and make recommendations to the RUC based on their areas of expertise. The RUC requires the most rigorous methodology for these surveys, recently increasing the minimum survey size and establishing a centralized, online data collection process.
In the first quarter of 2019, the ACR advisors have been very active in reviewing new and revised CPT codes for rheumatology procedures and services based on new technology and changes in practice, as well as responding to requests from the CMS and the AMA. To date, the ACR has been involved with surveying new and revised codes to develop recommended values for presentation at the RUC for X-rays of the sacrum and newly revised evaluation and management (E/M) office visit codes.
The ACR frequently works in conjunction with other related specialty societies on CPT and RUC issues. In January, the ACR worked alongside the American College of Radiology on the diagnostic codes for X-ray of the sacrum (CPT codes 72200 and 72202) and a multiple specialty group for the E/M codes.