CMS to require prior authorization for cervical fusion with disc removal

CMS will use prior authorization to reduce unnecessary increases in the volume of covered outpatient spine services next year.

Beginning July 1, 2021, CMS will require prior authorization for cervical fusion with disc removal as well as implanted spinal neurostimulators.

The strategy aims to ensure Medicare patients receive necessary care, "while protecting the Medicare Trust Funds from unnecessary increases in volume by virtue of improper payments, without adding new documentation requirements for providers," the agency said in a Dec 2. announcement.

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