RBRVS and RVU are an integral part of physician practices. Most government and private payers use this system as a basis of physician payment. The system was implemented by Centers for Medicare and Medicaid Services (CMS) in 1992. Before implementation, a UCR (Usual, Customary and Reasonable) system was used. The prior system created issues due to payers interpreting the UCR differently.
Why use RVUs?
RVUs are a national standard used for productivity, budgeting, expenses, and bench marking. They are a CFOs dream come true!
RVUs do not represent monetary values; they represent the relative amount of physician work, resource, and expertise needed, to provide services to patients. The actual dollar amount of payment for the physician’s services result only when a conversion factor (CF), dollar per RVU, is applied to the Total- RVU.
Three components to RVUs:
- Work-RVU are the direct expenses associated with what physicians receive for payment in salary and benefits.
- Practice Expense RVU (pRVU) represent the cost in which operate the medical practice.
- Malpractice RVU (mRVU) are the estimate of relative risk in each CPT code.
The MEDITECH Web Ambulatory system has the ability to collect all RVUs, and can be reviewed daily, monthly and/or yearly. The facility can run reports based off of several different criteria’s, including: full RVU, work RVU, facility, charge, provider, location and performing provider. They can then be narrowed down by procedure code, visit location, revenue site and performing location. Next, they can be downloaded as an excel file, as a summary report or detailed report, that will be used to create custom reporting in the form of pivot tables. The final information is then used in numerous ways, but the most valuable is measuring physician productivity and compensation.
In MGMA’s 2010 Report, 35 percent of group practices were using RVU compensation/productivity metrics, and 61 percent of physicians had their compensation/productivity tied to RVUs. MEDITECH Web Ambulatory makes this possible via Financial Status Desktop RVU function. The information is collected in the background, by the physician, just by simply using the Expanse Ambulatory application during the workday.
CereCore can assist with the system build process and help maximize revenue by getting the most current CMS, RVU file. This creates build for Charge Description Master with the latest RVUs. CereCore will assist in the process development for reviewing, and using, these reports to help train physicians and staff about the importance of appropriate and timely coding. CereCore can also help develop a plan to ensure the system RVU is relative with changes that CMS may make. This ensures latest values in system dictionaries. To start a conversation, please email us at email@example.com or call us at 855.276.9112.