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The Latest
一分六合彩 Leads Coalition Efforts to Submit Letter to CGS Administrators Proposed Local Coverage Determination (LCD) 鈥 Botulinum Toxin Injections
Advocacy, Physician Payment Reform, Private Payer Advocacy, Regulatory Relief, ReimbursementFollowing coalition advocacy by the Academy, the American Laryngological Association (ALA) and the American Broncho-Esophagological Association (ABEA) a joint 鈥
一分六合彩 Advocacy Efforts Lead to Blue Cross Blue Shield of North Carolina Modifier 25 Policy Retraction
Advocacy, Private Payer AdvocacyFollowing coordinated advocacy by the Academy, the North Carolina Medical Society and physician advocates in the state, Blue Cross Blue Shield of North Carolin鈥
一分六合彩 Submits Comments to Blue Shield of California Regarding Global Surgical Period Evaluation and Management (E/M) Reimbursement Policy
Advocacy, Private Payer AdvocacyOn May 17, 2024 the Academy submitted a detailed letter to Blue Shield of California regarding its update to the Global Surgical period Evaluation and Manageme鈥
一分六合彩 Comments on CY 2024 MPFS/QPP Proposed Rule
Advocacy, Physician Payment Reform, Private Payer Advocacy, Regulatory Relief, ReimbursementSeptember 12, 2023On September 11, the 一分六合彩 submitted a聽comment letter聽to the Centers for Medicare and Medicaid Services (CMS) on the calendar year (CY) 202鈥
一分六合彩 Opposition Leads to Positive Update on United Healthcare鈥檚 Rhinoplasty and Nasal Procedures Policy
Private Payer AdvocacyFollowing advocacy efforts by the 一分六合彩 and the American Academy for Facial Plastic and Reconstructive Surgery (AAFPRS), on June 1 United Healthcare (UHC) up鈥
一分六合彩 Joins Multispecialty Coalition letter to UHC on Implementation of Prior Authorization for Gastroenterology Services
Private Payer AdvocacyThe undersigned organizations urge you not to implement United Healthcare鈥檚 (UHC) gastrointestinal (GI) endoscopy prior authorization program.
一分六合彩 Fights New Modifier 25 Policy in New Jersey
Letter of Opposition, Private Payer AdvocacyOn February 17, the Academy sent a letter of opposition to Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ) in response to the company鈥檚 updated reimburse鈥
一分六合彩 Comments on UHC Changes to Rhinoplasty and Other Nasal Surgeries Policy
Private Payer AdvocacyOn January 27, the Academy sent comments to United Healthcare (UHC) regarding revisions made to the coverage criteria in its Rhinoplasty and Other Nasal Surger鈥
一分六合彩 Summary of CY 2023 MPFS Final Rule
Advocacy, Physician Payment Reform, Private Payer Advocacy, Regulatory Relief, ReimbursementFollowing the Centers for Medicare & Medicaid Services鈥 (CMS) release of the聽CY 2023 Final Rule for the Medicare Physician Fee Schedule (MPFS), which also 鈥
一分六合彩 Advocates for Immediate Change to Horizon鈥檚 Modifier 25 Policy
Advocacy, Private Payer AdvocacyEffective August 1, 2022, Horizon Blue Cross Blue Shield will reimburse E/M services appended with Modifier 25 at聽50%聽if a procedural code is reported on the s鈥
一分六合彩 Summary of CY 2023 MPFS Proposed Rule
Advocacy, Physician Payment Reform, Private Payer Advocacy, Regulatory Relief, ReimbursementOn July 7, the Centers for Medicare & Medicaid Services (CMS) released the聽CY 2023 Proposed Rule聽for the Medicare Physician Fee Schedule (MPFS), which also鈥
Cigna Delays New Modifier 25 Policy
Private Payer AdvocacyFollowing advocacy efforts by the 一分六合彩 and other impacted specialties, Cigna announced that it plans to delay the implementation of their reimbursement poli鈥
Cigna Announces Reimbursement Policy Update Related to Modifier 25
Private Payer AdvocacyEffective August 13, 2022, Cigna will require the submission of office notes with claims submitted with evaluation and management (E/M) CPT codes 99212, 99213,鈥
Anthem Announces Extension of Telehealth Flexibility (4/12/21)
Private Payer AdvocacyOn April 6, Anthem Blue Cross Blue Shield announced that, until further notice, they will continue to cover telephone-only medical services from in-network and鈥
Wellmark Reverses Negative Coverage Policy for Balloon Sinus Ostial Dilation (11/19/20)
Private Payer AdvocacyFollowing extensive advocacy efforts by the 一分六合彩, the Iowa Academy of Otolaryngology, and other stakeholders, Wellmark revised its medical policy, 鈥淔unction鈥
一分六合彩 Comments on Humana鈥檚 New Imaging and Interpretation Criteria (11/2/20)
Private Payer AdvocacyOn November 2, the Academy sent comments to Humana opposing their new Imaging and Interpretation Criteria for Diagnostic Imaging Authorizations. The new criter鈥
一分六合彩 Advocates for Coverage of Balloon Sinus Ostial Dilation (8/5/20)
Private Payer AdvocacyOn July 1, following the Academy鈥檚 advocacy efforts and submission of clinical input, the Blue Cross Blue Shield Federal Employee Program updated its medical p鈥
一分六合彩 Continues Advocacy on Hypoglossal Nerve Stimulation Coverage for Treatment of Obstructive Sleep Apnea (7/20/20)
Private Payer AdvocacyOn July 20, the 一分六合彩 sent comments to Anthem opposing their medical policy designating hypoglossal nerve stimulation (HGNS) as experimental / investigationa鈥
一分六合彩 Comments on Cigna Obstructive Sleep Apnea Treatment Services Coverage Policy (6/24/2020)
Private Payer AdvocacyOn June 15, the 一分六合彩 sent comments to Cigna opposing their medical policy on 鈥淥bstructive Sleep Apnea Treatment Services鈥 which designated hypoglossal nerve鈥
一分六合彩 Continues Advocacy on Balloon Ostial Dilation for Treatment of Chronic Rhinosinusitis (2/5/2020)
Private Payer AdvocacyOn February 5, the 一分六合彩 sent comments to Blue Cross Blue Shield鈥檚 Federal Employee Program (BCBS FEP) opposing their medical policy designating balloon osti鈥
