First, a sincere thank you to Linda Walsh at the AAP for this update. Linda is like a sharp dagger who cuts through all of the baloney for me when I get confused about some CPT or RVU issue. She must get a dozen questions (or more) a day from AAP folks and always answers them quickly, graciously, and – most importantly – correctly. And she even responds that way to me!
So…race to the URLs below to see the latest information from the AAP about 2008 RVUs, etc.:
(AAP public site)
(AAP Member Center)
- http://www.aap.org/visit/rbrvsbrochure.pdf [link removed]
(direct link to RBRVS Brochure)
- http://www.aap.org/visit/RBRVSConversionSpreadsheet.xls [link removed]
(direct link to RBRVS Conversion Spreadsheet)
Here’s the most important section from the brochure:
2008 Medicare Conversion Factor = $34.0682 (Note that this is an 11% reduction!)
Additional components of the Medicare RBRVS physician fee schedule factored into the payment structure include the following:
- MEI: The allocation of RVUs to pools for physician work, practice expense, and professional liability insurance, have been revised to correspond with the Medicare Economic Index. Work is now allocated 52% of the total RVUs, practice expense is 44%, and professional liability insurance is 4%.
- HPSA: Incentive payments for physician services provided to patients in Health Professional Shortage Areas (HPSAs), which are medically underserved communities, urban and rural locations that have a documented shortage of medical professionals.
- Non-Par Physician: Reduced payments for physicians, called “non-participating” physicians, who do not accept “assignment,” the Medicare approved amount that consists of the 80% Medicare payment and the 20% patient co-payment, as payment in full for services rendered to Medicare recipients.
- Budget Neutrality: Statutory guidelines indicate that revisions to the RVUs for physician services may not alter physician expenditures within the Medicare RBRVS physician fee schedule by more than $20 million from the principal expenditures that would have resulted if the RVU adjustments were never initiated. CMS normally maintains Medicare budget neutrality exclusively via annual adjustments to the Medicare Conversion Factor. However, in 2008 the Medicare program will additionally apply a separate budget neutrality adjustment factor to the physician work RVUs to ensure Medicare budget neutrality in light of work RVU increases tied to the 2005 Five-Year Review.