Fam Pract Manag. 2018 Nov-Dec;25(6):34.


Alternative payment models and value-based payments may be increasing in medicine, but most physicians still receive incentive pay tied to relative value units (RVUs). Knowing how many RVUs you generate for each office service you perform can help improve your productivity. RVUs change annually, however. The AAPC, which trains and certifies medical coders, maintains an online work RVU calculator that is regularly updated, but to ensure accuracy ask your office manager or coder for the set of RVUs your practice follows. Having a reference that lists codes and RVUs for common office visits and procedures will help you quickly determine which ones are more productive. For example, if you are seeing a new patient who was discharged from the hospital eight days ago and whose office visit meets the criteria for moderate complexity, you can charge either 99204, “level 4 new patient office visit,” or 99495, “transitional care management services with moderate medical decision complexity” (assuming your office made the required telephone call within two business days of discharge and that other transitional care management requirements are met). Which one should you charge? Code 99204 generates 2.43 work RVUs while 99495 generates 2.11 work RVUs, at roughly the same payment rate, so 99204 would have higher production.


Whenever I see a patient with a sore throat, before the physical examination I explain to the patient (or the patient's parent or guardian) that he or she has pharyngitis, which is either viral or bacterial. I then tell the patient that if it's caused by bacteria we must treat with antibiotics, but if it's a virus we must not treat with antibiotics because doing so may be hazardous. I have found that after this explanation patients


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