One way AGS can influence Medicare reimbursement is through policy advocacy; another, complementary, way is by participating in the process by which Medicare reviews, revises and approves Current Procedural Terminology, or "CPT," codes. Changes in CPT codes can have a significant effect on recognizing the work of caring for geriatric patients.

When creating the physician fee schedule for new and revised CPT codes, the Centers for Medicare and Medicaid Services (CMS) regularly considers recommendations from a committee convened by the American Medical Association (AMA), the Resource-Based Value Scale Update Committee or "RUC." In addition, a special RUC Five-Year Review Subcommittee reviews existing potentially mis-valued CPT codes and advises CMS on more appropriate relative value units to these codes twice a decade. AGS members are eligible to run for a seat on the RUC - Meghan Gerety, MD, both headed the most recent Five-Year Review Subcommittee and won a two-year term on the RUC last April - because a significant number of AGS members are also members of the AMA.

"To continue to have members on the RUC and other important AMA panels, we need to ensure that a sufficient number of AGS members are also members of the AMA," AGS member Peter Hollmann, MD, told AGS and Association of Directors of Geriatric Academic Program (ADGAP) board members and policy leaders at a recent public policy planning session. (See related story) "As members of these panels, we can represent the interests of older patients and geriatrics."

Under AMA bylaws, medical specialty societies can have a seat in the AMA's House of Delegates (HoD) - its principal policy-making body - if at least 1,000 of their physician members are also members of the AMA. AGS just makes the cutoff, with a little over 1,000 physician members who are also AMA members.

The benefits of a seat in the HoD are tremendous. AGS' seat in the HoD not only qualifies AGS members to run for a seat on the RUC, it also guarantees AGS a spot on the AMA's RUC Advisory Committee, which makes recommendations to the RUC. AGS member Alan Lazaroff, MD, is currently a member of the RUC Advisory Committee. AGS member Holly Stanley, MD, is an alternate RUC member.

Because AGS has a seat in the HoD, AGS members are also eligible to be appointed to the AMA's CPT Editorial Panel --which creates and revises the CPT codes for which the RUC then proposes values to CMS. Thanks to its HoD seat, AGS also gets a spot on the CPT Advisory Committee, which supports and advises the Editorial Panel by, among other things, reviewing proposals for new codes from specialty societies. Dr. Hollmann was appointed to a seat on the CPT Editorial Panel in 2003, becoming the first AGS nominee to be appointed to the panel. Robert Zorowitz, MD, is AGS' representative to the CPT Advisory Committee. Having a seat on the HoD affords AGS yet another benefit -- a seat and a vote on the AMA's Physician Consortium for Performance Improvement (PCPI). The Consortium is charged with developing both clinical performance measures and outcomes reporting tools for physicians.