CMS releases update on OPPS prior authorization beginning July 1

The Centers for Medicare & Medicaid Services has identified the Healthcare Common Procedure Coding System billing codes for hospital outpatient services that will require prior authorization starting July 1 under the hospital outpatient prospective payment system final rule for calendar year 2020. Under the rule, the prior authorization requirement will apply to five categories of services: blepharoplasty, botulinum toxin injections, panniculectomy, rhinoplasty and vein ablation. CMS will post additional information about the prior authorization program on its website as operational details are finalized.