Could there be a new CPT code coming for prior authorization work?

Medical Economics March 7, 2024
Richard Payerchin

American Medical Association’s code panel has it on the agenda this spring.

Medical experts could consider creating new billing codes for time physicians and their support staff spend working on prior authorizations.

The American Medical Association’s (AMA) Current Procedural Terminology (CPT) Editorial Panel is scheduled to meet May 9 to 11 in Chicago. Its meeting agenda includes three potential new CPT codes “to report services (physician, QHP, Clinical Staff) related to [payer] authorization of procedures,” referring to qualified health plans.

What does it say?

Proposals for new codes may come from industry, medical specialty societies, government, health plans, hospitals and others. AMA does not disclose identities of applicants because their requests may have proprietary information.

But the agenda included a...

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