The Alliance improved CMS’ understanding of CTPs and their use in real-world clinical practice via an educational seminar customized to key CMS senior policymakers and staff who oversee policies guiding HCPCS coding, the physician fee schedule and hospital outpatient payments. This meeting was the direct result from our March meeting with CMS staff to elevate CTP issues and Alliance recommendations. The June 27 educational session was attended by six CMS Directors or Deputy Directors along with 18 senior staff from these distinct divisions of the Agency: Hospital and Ambulatory Policy Groups (Division of Practitioner Services, Division of Outpatient Care, Division of Ambulatory Services); Technology Coding and Pricing Group (Division of Coding and DRG; Division of Data Analysis and Market Based Pricing); Chronic Care Policy Group (Division of Home Health and Hospice); and Center for Clinical Standards and Quality (Coverage and Analysis Group. In addition to providing much needed education about CTPs and their use, we also took advantage of the advocacy opportunity to demonstrate the unintended impacts being experienced by clinicians and patients under current coding policies and called on the Agency to bring consistency to coding for CTPs and synthetic CTPs. See the slides that guided our presentation and our recommendations to CMS, below.

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