News Briefs: April 17, 2023

In an April 13 MLN Connects, CMS reminded providers that facet joint interventions will join the list of procedures that are subject to the hospital outpatient prior authorization process on July 1.[1] Also, CMS on April 11 reminded hospital outpatient departments about prior authorization for certain procedures: “As part of the Calendar Year 2023 Outpatient Prospective Payment System/Ambulatory Surgical Center Final Rule (CMS-1772-FC), CMS added Facet Joint Interventions to the nationwide prior authorization process for hospital outpatient department (OPD) services. OPD providers can start submitting the prior authorization requests on June 15, 2023, for dates of service on or after July 1, 2023. This service category will be in addition to the existing list of services requiring prior authorization, which are blepharoplasty, botulinum toxin injection, rhinoplasty, panniculectomy, vein ablation, implanted neurostimulators, and cervical fusion with disc removal. OPD providers that are currently exempt from submitting prior authorization requests will stay exempt for all eight service categories combined, including new services.”[2]

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