Monday, July 12, 2010

What is RBRVS AND RVU

Resource Based Relative Value Scale (RBRVS)

The Center for Medicare and Medicaid Services (CMS, formerly HCFA) assigns each medical procedure a:

1) relative value reflecting the physician work involved in the service (work RVU),
2) relative value reflecting the practice expense generated by the procedure (practice expense RVU), and
3) relative value representing the cost of professional liability needed to provide the service (professional liability RVU)

Physician Payment by Medicare - RBRVS, RVU

Relative value unit RVU - determines how much is paid for any service based on 3 factors:
Physician Work RVU - physician time & intensity
+ Practice Expense RVU - based on overhead
+ Malpractice cost RVU - cost of liability insurance
= Total RVU X Conversion Factor = Payment


ICD, CPT, RBRVS, RVU, GPCI
• ICD - International Classification of Diseases
• CPT - Current Procedural Terminology
• RBRVS - Resource Based Relative Value Scale
• RVU - Relative Value Unit
• GPCI - Geographic Practice Cost Index

0 comments:

Medicare physician fee schedule - Quick overview

Medicare Part B pays for physician services based on the PFS, which lists the more than 7,400 unique
covered services and their payment rates. Physicians’ services include the following:

* Office visits;
* Surgical procedures;
* Anesthesia services; and
* A range of other diagnostic and therapeutic services.


Medicare Physician Fee Schedule Payment Rates

Payment rates for an individual service are based on
three components:
1) Relative Value Units (RVU)
2) Conversion Factor (CF)
3) Geographic Practice Cost Indices (GPCI)


Medicare Physician Fee Schedule Payment Rates Formula


The Medicare PFS payment rates formula is shown below:

[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
(MP RVU x MP GPCI)] x CF

Medicare fee schedule download