Physician Payments: Relative Value Units Last week we learned the calculation of payments for physician services.P...

Physician Payments: Relative Value Units

Last week we learned the calculation of payments for physician services.P

RVU Information

2012: Code 44389 Work 3.13; PE (Non Facility) 8.4; PE (Facility) 1.91; MP 0.49

Code 58800 Work 4.66; PE (Non Facility) 4.12; PE (Facility) 3.56; MP 0.79

Code 13100 Work 3.17; PE (Non Facility) 5.56; PE (Facility) 3.28; MP 0.50

Conversion Factor $34.0376

GPCI Information.

2012: Work GPCI: 0.998 PE GPCI: 0.981 MP GPCI: 0.619

Code	Description	Work RVU	Work GPCI	PE RVU	PE GPCI	MP RVU	MP GPCI	FAC TOTAL RVU	Total Payment
*2012*	*Conversion Factor $34.0376*
44389	Colonoscopy with bioposy –Non Facility
44389	Colonoscopy with bioposy – in Facility
58800	Ovarian Cyst – Non Facility
58800	Ovarian Cyst – Facility
13100	Wound Repair – Non Facility
13100	Wound Repair - Facility

II. Budget Neutrality Though a committee of physicians set the RVU (work, practice expense, and malpractice) values (and consequently can inflate physician payments by continuously increase the RVU values), CMS is required to control overall expenditures. Search online for information on “Budget Neutrality” for physician RVU based payments from Medicare and provide a brief summary of how Medicare can control its physician costs.

Expert Solution

jeff jeffy answered 2 years ago

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H458 Application Exercise 5 – Physician Services Physician Payments: Relative Value Units Last week we learned the calculation of payments for physician services.P RVU Information 2012: Code 44389 Work 3.13; PE (Non Facility) 8.4; PE (Facility) 1.91; MP 0.49 Code 58800 Work 4.66; PE (Non Facility) 4.12; PE (Facility) 3.56; MP 0.79 Code 13100 Work 3.17; PE (Non Facility) 5.56; PE (Facility) 3.28; MP 0.50 Conversion Factor $34.0376 GPCI Information. 2012: Work GPCI: 0.998 PE GPCI:...

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