Over the last few years, pediatricians have gained a lot of ground in the RVU arena – I have documented many of the changes, as you know. Although it sometimes feels like two steps forward and one step back, the overall RVUs/Visit for PCC client have increased from 1.77 in 2003 to 2.95 in 2012 – although better coding and a smaller Sick:Well visit ratio contribute to that massive change, increased RVUs for imms admins, E&Ms, and well visits have helped a lot.
The big reason for this change, imo, is the ramped-up effort of the AAP in the national arena. However, they need your help. They need you to participate in the RUC survey process and get some RVU values for two new key code families that affect you every day: complex chronic care coordination (CCC) and transitional care management (TCM) services!
Here’s the note from the AAP. You only have to donate your time and you will certainly learn something about your practice. And if you don’t participate, you can’t complain later that CMS got it wrong.
Dear AAP Members:
We are writing to let you know that the American Academy
of Pediatrics (AAP) and other medical specialty societies will be
conducting an AMA/Specialty Society Relative Value Scale Update
Committee (RUC) survey beginning June 18th.
We will need your input regarding the appropriate valuation of two new
CPT code families for complex chronic care coordination (CCC) and
transitional care management (TCM) services.
new CPT codes were approved during the May 2012 CPT Editorial Panel
meeting. The next step is to develop relative value recommendations for
the new codes. Your participation in this process will help ensure that
we present accurate and fair value recommendations to the RUC, which
will then forward its final valuation recommendations to the Centers for
Medicare and Medicaid Services (CMS) for consideration on the Medicare
Resource-Based Relative Value Scale (RBRVS) physician fee schedule.
If you have not completed a RUC survey before, the attached presentation
includes information to help guide you through the process.
If you do not perform these CCC or TCM services, are not a United States physician, or are a commercial representative, please do not
complete the surveys. On the other hand, if you have colleagues
eligible/interested in completing the surveys, you may forward the
surveys to them, provided they meet the aforementioned criteria.
The survey will start on approximately June 18th.
Please expect to receive another e-mail from me at that time, embedded
with a link to the online survey tools. We will be requesting completion
of the surveys by July 2nd.
We look forward to seeking your input. If you have any questions, please contact Linda Walsh, AAP staff, at hidden@email-address.
Thank you for your time and expertise,
Steve Krug, MD, FAAP
AAP RUC Advisor
Rich Molteni, MD, FAAP
AAP CPT Advisor
is an overview of the services that we’ll be surveying. Thank you in
advance for your time and attention to this important matter.
Complex Chronic Care Coordination Services (CCC)
chronic care coordination services are patient centered management and
support services provided by physicians, other qualified health care
professionals and clinical staff to an individual who resides at home or
in a domiciliary, rest home or assisted living facility. These services
typically involve clinical staff implementing a care plan directed by
the physician or other qualified health care professional. These
services address the coordination of care by multiple disciplines and
community service agencies. The reporting individual provides or
oversees the management and/or coordination of services, as needed, for
all medical conditions, psychosocial needs and activities of daily
Transitional Care Management Services (TCM)
Care Management codes are used to report transitional care management
services. These services are for an established patient whose medical
and/or psychosocial problems require moderate or high complexity medical
decision making during transitions in care from an inpatient hospital
setting (including acute hospital, rehabilitation hospital, long-term
acute care hospital), partial hospital, observation status in a
hospital, or skilled nursing facility/nursing facility, to the patient’s
community setting (home, domiciliary, rest home, or assisted living).
TCM commences upon the date of discharge and continues for the next 29
Jose F. Lopez
Manager, Practice Management
American Academy of Pediatrics
Your opportunity to participate in the RUC surveys is open and ends on 07/10/12…so get on it!
This is the latest from the AAP:
As indicated in my previous e-mail on June 14th [embedded below], I am
now sending you the survey links for the following RUC valuation
Transitional Care Management CPT Codes (TCM) [2 codes]
Chronic Complex Care Coordination CPT Codes (CCC) [3 codes]
If you do not perform these CCC or TCM services, are not a United States
physician, or are a commercial representative, please do not complete