February 29, 2024

ACR Recommends CPT Code Placements for 2025 Medicare Hospital Outpatient Prospective Payment System

The American College of Radiology®(ACR®) submitted recommendations to the Centers for Medicare and Medicaid Services (CMS) regarding the placement and reimbursement of new Current Procedural Terminology® (CPT®) codes preceding the 2025 Hospital Outpatient Prospective Payment System (HOPPS) proposed rule.

The recommendations outline ACR’s position on the proposed ambulatory payment classification (APC) for codes describing transurethral ultrasound ablations, a newly defined urology service involving treatment planning, transducer insertion and ablations done with an MRI-monitored TULSA system. The College suggests these codes are most appropriately placed in APC 5374–Level 4 Urology and Related Services. ACR also recommends placing the newly established code reporting percutaneous radiofrequency ablation of the thyroid into a Level 1 Laparoscopy category.

New codes were established to report magnetic resonance (MR) examination safety procedures for patients with MR-compatible implanted devices; ACR in its recommendations outlines the proposed placement for each aspect of treatment preparation. The APC placements in different categories dictate the reimbursement for services performed. CMS will review recommendations for placement of new CPT codes in preparation for the HOPPS proposed rule to be released this summer.

For questions, contact Kimberly Greck, ACR Senior Economic Policy Analyst, or Christina Berry, ACR Team Lead, Economic Policy.