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Background In the CY 2017 PFS final rule (81 FR 80330 through 80331), we finalized payment for new CPT code(s) describing administration of a patient-focused health risk assessment instrument as well as administration of a caregiver-focused health risk assessment instrument
The rest of the seven come from a pelvic exam that can include any of the following areas (with or without specimen collection for smears and cultures): External genitalia, Urethral meatus, Urethra, Bladder, Vagina, Cervix, Uterus, Adnexa/parametria, Anus and perineum
Additionally, we estimate 5 APM Entities will submit an extreme and uncontrollable circumstances exception application to reweight one or more MIPS performance category for the CY 2025 performance period/2027 MIPS payment year
We also note that the intensity of CPT code 25310 is decreasing, not increasing, as recommended by the RUC which further suggests that a work RVU of 9.50 would not be appropriate for this code given the surveyed work times
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