The CPT Editorial Panel, which is responsible for maintaining “the language of medicine,” also known as the Current Procedural Terminology (CPT®) code set, will add new voices and perspectives from people fluent in the expanding vocabulary of medicine.

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Specifically, the CPT Editorial Panel, which holds multiple meetings a year and ensures that CPT codes reflect the latest medical care provided to patients, is expanding from 17 to 21 members.

The expansion is aimed at increasing the expertise available to the CPT Editorial Panel as coding content advances to reflect the emergence of digital health, diagnostic precision medicine and augmented intelligence.

The new CPT Editorial Panel positions will be open to:

  • Two physicians nominated by a medical specialty society.
  • A nominee from either an umbrella organization that represents private health care insurers or a medical specialty society.
  • A member of an at-large organization.

To qualify as an at-large organizational member, the person must be:

  • Part of an organization that has historically participated in the CPT code change application, formal review, or CPT Editorial Panel deliberation process and previously did not have the ability to nominate membership—such as a group that is not a medical specialty society or an umbrella organization that represents private healthcare insurers.
  • A physician knowledgeable in medical or health care procedure nomenclature and coding and committed to maintaining the CPT code set in accordance with the highest professional standards.

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Opportunity for new voices

“The Panel isn’t filling knowledge gaps, but offering an opportunity to bring new voices to the CPT Editorial Panel,” said Jay Ahlman, the AMA’s vice president of coding and reimbursement policy and strategy.

“The payer umbrella organization seat offers the opportunity for an organization like the Council for Affordable Quality Healthcare to nominate someone,” Ahlman said. “The new at-large organization seat offers those representing innovators and others that have been engaged in the process but could not get someone on the panel to nominate someone for consideration.”

All new CPT Editorial Panel members must be an MD or DO, Ahlman said.

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The new members will be observers at the February 2022 panel meeting and will be able to vote beginning with the May 2022 meeting. To stagger the terms, two of the four members will be randomly selected to start their tenure with a two-year term. The other two will have an initial four-year term.

Of the 17 current panelists, two are represented by the Chair and Vice Chair of the Panel, 10 are physicians nominated by national medical specialty societies and approved by the AMA Board of Trustees, one each is represented by the Blue Cross and Blue Shield Association, America’s Health Insurance Plans, and the American Hospital Association, and the two remaining seats are reserved for members of the CPT Health Care Professionals Advisory Committee (HCPAC). The Centers for Medicare and Medicaid Services has two individuals that serve as a liaison role between the Panel and the Agency.

During the COVID-19 pandemic, the CPT Editorial Panel met requests by the Centers for Disease Control and Prevention and CMS to develop CPT codes that enabled them to track COVID-19 vaccines and vaccine administration. Also, the codes’ specificity allows for data reuse to support tracking for “long-haul” patient research.

Other notable recent additions to the CPT lexicon include codes for physicians adopting a collaborative care model, therapeutic remote monitoring and remote physiologic monitoring.

The next meeting (PDF) of the CPT Editorial Panel will be virtual and is scheduled for Sept. 30-Oct. 2.

The CPT Editorial Panel supports diversity, equity and inclusion in its members and its policies. The AMA encourages highly motivated, qualified candidates of all backgrounds who meet the criteria outlined for CPT Editorial Panel membership to apply for these positions. All nominees are subject to AMA Board of Trustees’ approval.

Learn about implementing CPT Evaluation and Management (E/M) revisions and the recent technical corrections (PDF).

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