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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.

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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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