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Last Modified: 7/9/2020 Location: FL, PR, USVI Business: Part A

Prior authorization program for certain hospital outpatient department services

Delivery language: English

The Centers for Medicare & Medicaid Services (CMS) is implementing a prior authorization program for certain hospital outpatient department (OPD) services for dates of service (DOS) on or after July 1, 2020. As a condition of payment for DOS on or after July 1, a Prior Authorization Request (PAR) is required for the following hospital OPD services:
Blepharoplasty, eyelid surgery, brow lift, and related services
Botulinum toxin injections
Panniculectomy, excision of excess skin and subcutaneous tissue (including lipectomy), and related services
Rhinoplasty and related services
Vein ablation and related services
Throughout the initial weeks of July, First Coast will offer five separate service-specific webcasts relating to this new program and addressing each of the above topics separately. Register for these individual webcasts below.
If your facility bills these services, or you are a provider performing these services on Medicare beneficiaries, join us for these webcasts. We’ll review the guidelines for submitting a PAR and the potential results and options available, details of the Local Coverage Determinations and additional resources available to assist.
To register for this event, you must have an account in First Coast University, our learning management system. Learn how to create an account if you don’t have one.

Panniculectomy and related services

Tuesday, July 14

11-12:30 p.m. ET

Rhinoplasty and related services

Wednesday, July 15

10-11:30 a.m. ET

Vein ablation and related services

Thursday, July 16

10-11:30 a.m. ET

Would you like to submit questions prior to this event? You may submit your questions in advance by emailing them to Please submit your questions no later than Monday, June 26.
AAPC accepts hour for hour CMS CEUs when sponsored by CMS national or MAC offices. A certificate of attendance or completion with the CMS logo is necessary to show participation. To claim CEUs attendees will enter certificate information onto their CEU Tracker using the "No Index Number" option. A copy of the certificate does not need to be provided to AAPC unless the member is selected for verification purposes.
Please click here for CEU documentation instructions.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.