Federal health research tackles kidney disease
Researchers with the Advanced Research Projects Agency for Health (ARPA-H) recently discussed the next phase of their work on chronic kidney disease with AMA staff. ARPA-H funds projects that utilize advanced technologies, including AI and machine learning, to drive biomedical breakthroughs that can be scaled to quickly reach large numbers of people.
The recent discussion of chronic kidney disease, which included the Renal Physicians Association as well as AMA staff, focused on the role of CPT coding to reflect services provided to patients, and related policies for services that could screen large numbers of patients for kidney disease at an early stage and get them into treatment to prevent its progression to more advanced renal and cardiovascular disease.
AMA and OIG discuss recent report on post-operative visits
The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) staff and AMA staff recently met to discuss the OIG’s June 2025 Report: CMS Should Improve Its Methodology for Collecting Medicare Postoperative Visit Data on Global Surgeries (PDF). The report focused on data collection requirements from the Centers for Medicare & Medicaid Services (CMS) for post-operative visits by certain practices in certain states, including an audit of global surgery codes from 2018 that reported at least one post-operative visit using CPT code 99024. OIG found that many post-operative visits were not reported because physicians and their staff were unfamiliar with CMS’ data collection requirements, or their billing systems were not designed to always submit the non-payable CPT code 99024 on claims to CMS. The AMA raised similar concerns about the inaccuracies of 99024 in Medicare claims data in response to a RAND report in our comment letter (PDF) on the 2022 Medicare Physician Payment Schedule proposed rule.
Despite these findings, OIG concluded that reported data shows that surgeons are often not furnishing as many post-operative visits included in 10- and 90-day global surgery code valuations and recommended CMS take action to revalue global surgery codes. The AMA, therefore, met with OIG to explain the AMA/Specialty Society Relative Value Scale Update Committee (RUC)’s process and progress (PDF) in identifying and reviewing misvalued codes. In particular, the RUC has revalued a number of global surgery codes since 2018, and is reviewing knee replacement surgery, which is mentioned in the report, at the Sept. 2025 meeting. AMA staff will continue to keep OIG apprised of these efforts as OIG is separately conducting a related audit covering surgeries for which CMS expected postoperative visits to be provided but none were reported, as noted in the June 2025 report.
Reminder: Re-opened Physician Compare preview period closes Aug. 21
CMS reopened the calendar year (CY) 2023 Doctors and Clinicians (DAC) preview period because updates were made to the CY 2023 Quality Payment Program (QPP) performance data available during the preview period that closed in June. As a result, CMS is encouraging all clinicians and groups to review their Merit-based Incentive Payment System (MIPS) performance information again for any changes, even if they already reviewed their information during the previous preview period, before the current preview period closes on Aug. 21, 2025, at 8 p.m. Eastern time. During the re-opened preview period, physicians once again can inform CMS if they would like to opt out of having their 2023 MIPS data posted on Care Compare. If you already opted out of having your 2023 data publicly posted, CMS will maintain the opt-out unless the physician indicates the change in status.
