Do you know your RVUs?

Many physicians receive payment tied in some way to productivity as measured by relative value units (RVUs). As Megan Lykke, MD, writes in Practice Pearls, “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.”

To create your list of RVUs for common codes, you can ask your office manager or coder for the set of RVUs your practice follows, consult the AAPC online work RVU calculator https://www.aapc.com/practice-management/rvu-calculator.aspx, or download Excel files from the Centers for Medicare & Medicaid Services (CMS) at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/PFS-Relative-Value-Files.html.

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Posted on Oct 24, 2019 by FPM Editors