Explore the history and development of the relative value unit (RVU) system
Explain the current formula utilized to calculate RVUs
Provide the neurointerventionalist with current examples of RVU calculation for many common neurointerventional procedures
Introduction/purposeThe Resource-based relative value scale (RBRVS) was established in order to assign a specific value to physician services. Procedures performed by physicians are assigned a relative value unit (RVU). Physician groups often evaluate the RVU production of their partners as a performance measure of physician productivity and value. This presentation will explore the components of the RVU system and how physicians are reimbursed under the RBRVS.
Materials/methods The formula for RVU calculation has three components: physician work, practice expense (PE) and malpractice expense. A geographic practice cost index (GPCI) is multiplied by each of these three components to account for the cost difference in medical practices across different geographical locations. A conversion factor converts the RVU values into a reimbursable dollar amount, which is $35.7547 per RVU for 2015. The formula for calculating the fee schedule amount is: Payment = [(RVU work x GPCI work) + (RVU PE x GPCI PE) + (RVU malpractice x GPCI malpractice) x Conversion Factor. Data for RVU calculation was obtained from the Centers for Medicare and Medicaid Services.
Results RVU values were calculated for 27 common neurointerventional procedures. 2015 RVU values and reimbursement rates were calculated. The 2015 reimbursement values were compared to 2013 values. 15/27 procedures demonstrate declining reimbursement since 2013.
Conclusion Physician management groups, practicing neurointerventionalists, and trainees should have an understanding of the RVU system and how payments for procedures are calculated. The total RVU calculation is constantly changing for individual procedures as the RVU values and conversion factors are updated. A strong knowledge of the process is important to understand how the RVU is derived. Some physician groups may conclude that the RVU is not necessarily the best measure of physician performance and production.
Disclosures R. Trojan: None. G. Snowden: None. V. Kadakia: None. M. Fortes: None.
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