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Professional- licensure, reimbursement, other

New CPT codes & reimbursement
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CEPA, along with ACSM and about a dozen other organizations, are working together as the Physical Activity Alliance (https://paamovewithus.org/) to determine how best to move forward seeking reimbursement for these new codes. Stay tuned to CEPA and ACSM for updates on when and how to submit these codes.

The typical timeline for movement from a Category III CPT code to a Category I code with Relative Value Units (RVUs) assigned and payment rate established is about 5 years. The initial 5 year investigation period can potentially be extended, as I think it will be given the COVID-19 PHE. That's just my opinion, though, I have not heard anything "official" in that regard.

This question was posted during the CEPA webinar on licensure & reimbursement (Jan 2021). Future reimbursement for services provided by CEPs based on newly released CPT codes was discussed. I understand there is no reimbursement for these CPT codes today, but should be begin using those codes if they apply in our environment? What are those codes? How do CPT codes get from proposal to reimbursement and what is the typical timeline?

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