A CPT Code for Thyroid RFA: Dr. Jon Russell
SAVE YOUR THYROID with Jennifer Holkem: Episode #89
Coming up in this episode:
“CMS finally said that they were going to give us a code and we all waited anxiously. They did surveys and they talked to whole bunch of different [medical] societies. And at the end of everything, they came back and they gave us a relative value unit of 5 .75 RVUs; meaning, approximately, they consider it less work on the part of a doctor than a consultation with the patient.” —Dr. Jonathon Russell
Today’s guest is Dr. Jonathon Russell. After training at the Cleveland Clinic, Dr Russell trained further at Johns Hopkins before spending almost 10 years there. He became the Chief of Head and Neck Endocrine Surgery at Johns Hopkins and was the director of the Thyroid Tumor Center. During that time, he was the first surgeon to complete transoral robotic surgery for thyroid cancer, led the largest series of transoral surgery in the West, and was the first group of Head and Neck Surgeons to offer RadioFrequency Ablation (RFA). In 2024, Dr Russell founded the Russell Center for Endocrine Health, where he continues to innovate as he offers each patient a personalized plan of care.
Today’s conversation centers around the topic of thyroid RFA and insurance coverage. Specifically, a CPT billing code that has been created by the CMS. For the past 5 years, many patients have been eagerly awaiting the creation of this code so that they could pursue treatment with the benefit of insurance coverage. The new code was just released, but unfortunately, has set the value of reimbursement too low for RFA to be financially sustainable in the outpatient clinic setting. In today’s episode, we’ll discuss what this could mean for the future of thyroid RFA, as well as actionable steps you can take to advocate for the future of this nonsurgical treatment option.
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What is this podcast and blog all about?
To my subscribers, welcome back! If you’re new, welcome to Save Your Thyroid, a podcast and blog all about thyroid nodules. My name is Jennifer Holkem, and I advocate for fellow patients suffering with this very common condition. Thyroid nodules impact 70% of adults in their lifetime, and the standard of care is surgical removal of half or all of the gland. But in recent years, safe and effective non-surgical treatment options have become available.
In this podcast and blog, I sit down with patients and physicians to discuss life with thyroid nodules, treatment options, and how to save the thyroid whenever possible.
Key Takeaways:
Dr. Russell transitioned to private practice to provide personalized care.
Radiofrequency ablation (RFA) is a growing minimally invasive treatment.
Insurance reimbursement for RFA has been a significant challenge.
CMS controls the reimbursement codes for medical procedures.
The lack of a specific code has led to confusion and denial of coverage.
RFA specialists are often the same doctors who follow up with patients.
There are risks associated with bilateral RFA procedures.
Patient advocacy is crucial in addressing healthcare access issues.
The new CMS code for RFA has both positive and negative implications.
Potentially, individuals can submit their comments to CMS before they finalize this decision.
Read the letter submitted by the American Association of Clinical Endocrinologists (AACE):
Click to download “2025 Physician Fee Schedule - CMS memo AACE CMS-1804-P”
https://www.regulations.gov/comment/CMS-2024-0256-5144
“Considering these concerns, AACE urges CMS to reconsider the reimbursement framework for RFA procedures, taking into account the full range of practice expenses, including essential consumables like the RF electrode. Ensuring fair and adequate reimbursement is essential to maintain access to this beneficial procedure for patients with thyroid nodules.” —
Susan Samson, MD, PhD, FACE
President, AACE
Submit your comments to the CMS about the CPT code for thyroid RFA:
👉Online: https://www.regulations.gov/comment/CMS-2024-0256-5144
👉Mail written comments to the following address:
CMS, Office of Strategic Operations and Regulatory Affairs, Division of Regulations Development, Attention: Document Identifier/OMB Control Number: CMS-2024-0256-0045, Room C4-26-05, 7500 Security Boulevard, Baltimore, Maryland 21244-1850
The goal of this podcast and blog
I seek to provide data, resources, and expert opinions on the topic of thyroid nodules, and make it accessible to patients. When I was first looking for thermal ablation treatment, everything that I read was physician-facing material. It was very hard for me to understand. This material is meant to help patients understand what's going on in their thyroid gland and what an important gland it is. If you can keep your thyroid intact, that's going to help you live a longer, healthier life, and preserve your quality of life. Thanks for reading this far today! — Jen
Connect with Dr. Jon Russell:
Russell Center for Endocrine Health
👉 Website: https://www.russell-center.com/
👉 Instagram: @jonrussellmd
Disclaimer: None of the statements made in this or any other video by "Its me Jen again" should be considered medical advice.
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