---
title: More 2008 RVU News (not good for some)
description: More 2008 RVU News (not good for some)
---

[Confessions of a Pediatric Management Consultant... Where fame and fortune await those who help keep pediatric practices alive and independent! ](https://chipsblog.pcc.com)

# [More 2008 RVU News (not good for some)](https://chipsblog.pcc.com/more-2008-rvu-news-not-good-for-some)

 Written by [Chip Hart](https://chipsblog.pcc.com/author/chip-hart) | Nov 21, 2007 1:16:20 PM

I was in the middle of re-stating these facts when I realized that Linda Walsh said it as well as I could:

> As you know, CMS once again implemented its work adjuster to allow for Medicare budget neutrality in light of the increases from the last Five-Year Review.
> 
> For 2008, the adjustment factor increased to 0.8806. CMS will adjust the work RVUs on each code submitted by this factor prior to payment of Medicare claims. Non-Medicare payers may or may not follow suit.

Two important points from this:

1. Because the PE portion of many codes continues to rise as a result of changes made two years ago (*e.g.*, E&M codes received a significant boost), the total value of each code is offset by a growing *reduction* to the Work portion. This is required because of CMS's "budget neutrality" rules which require them to maintain a constant budget. In English...CMS raised the values of a lot of codes, but in order to keep the total they pay out constant, they also lowered everything at the same time. Following this? I'll run some numbers in a week or two predicting the impact on pediatricians, but it will be slight.
2. *Much* more important is this line: "Non-Medicare payers may or may not follow suit." There is absolutely no valid reason, of which I am aware, that a private payer should be making "budget neutrality" adjustments to their payments. It's patently absurd and unethical, imo. Those adjustments are *purely* for Medicare legal reasons and are *not* part of the RBRVS valuation system. I know of some MCOs are that making this adjustment and some who aren't. Fight this, bitterly.

In a few weeks, I will update PCC's RVU calculators to reflect the 2008 data but will *not* be including the adjustment factor above.

[View full post](https://chipsblog.pcc.com/more-2008-rvu-news-not-good-for-some)

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