For Health Plans, the Final Rule on Price Transparency (CMS-1717-F2) goes into effect on July 1, 2022. Are you prepared to be compliant? According to the requirements, health plans and hospitals must publicly disclose a list of their standard charges for the items and services they provide as well as a list of shoppable services in a searchable and machine-readable format. The AMA is supportive of the final rule and its goals of better price transparency and public access to health plan and hospital standard charges.

In addition to the Current Procedural Terminology (CPT®) codes, health plans and hospitals may use CPT consumer-friendly descriptors to comply with the requirement of the final rule for a plain language description of services. These descriptions are already included in the CPT license for every code. Here is an example of a long descriptor and a consumer-friendly descriptor for the same CPT code:

CPT code 27217

For additional information on licensing please see our site on CPT licensing. If you have questions, please contact your AMA Account Representative, or email us at [email protected].

Copyright 2022 American Medical Association. All rights reserved.

Static Up
150
Featured Stories