CPT® Assistant article provides guidance on reporting prior authorization work
As shown by AMA physician survey data (PDF), health plans’ prior authorization (PA) requirements delay patient care and pose significant administrative burdens on practices.
A recently published CPT® Assistant article (PDF) adds to the AMA’s many PA resources by offering information about how physicians and their staff can report PA-related work using existing Current Procedural Terminology (CPT®) codes. As detailed in the article, PA-related activities completed on the date of an evaluation and management (E/M) service can be reported using E/M codes 99203–99205 and 99213–99215, as PA work is included in these codes’ descriptions of procedure. PA activities completed on a date other than an E/M service may be reported using 99358 (prolonged E/M service before and/or after direct patient care) if all the requirements associated with the code are met. Another potential option is 99080, which can be used to report work associated with completion of special reports and signing forms on a date other than an E/M visit. To access all the AMA’s PA advocacy resources, please visit FixPriorAuth.org.
Make your voice heard on key health care issues during this election cycle
As the election approaches, it is critical to make your voice heard on the key issues impacting physicians, patients and the health care environment. Below are some of the ways in which you can join the AMA in advocating for policies vital to our nation’s health care system during the election cycle—and at the start of a new administration and new Congress:
Attend the AMA National Advocacy Conference: The AMA National Advocacy Conference brings the power of organized medicine to our nation’s capital. Save the date for the 2025 AMA National Advocacy Conference—Feb. 10-12 at the Grand Hyatt Washington. Registration information will be available in early November.
Join the AMA Physician Grassroots Network: Connect with physicians from across the country and advocate for solutions to our nation’s health care challenges—no one is more qualified to help guide members of Congress as they draft, debate and enact health care legislation than those who deliver quality care to patients every day.
Become a member of the AMA Very Influential Physician program: Take on a leadership role in grassroots activities—and learn how to build and leverage connections with members of Congress to advance our shared agenda on Capitol Hill.
Find out more ways to get involved with AMA advocacy.
While the AMA is a nonpartisan organization and does not endorse presidential candidates, the following are several resources where you can learn more about the positions and proposed policies from the two major candidates and their campaigns on the health care issues that matter most to you and your patients:
“Where the presidential candidates stand on health care policy” - KFF
“Where Harris and Trump stand on top issues in health care” - MedPage Today
More articles in this issue
- Sept. 20, 2024: Medicare Payment Reform Advocacy Update
- Sept. 20, 2024: National Advocacy Update
- Sept. 20, 2024: State Advocacy Update
