A complete RBRVS resource is critical for developing a defensible fee schedule, analyzing reimbursement mix, negotiating reimbursement rates with payers, and ensuring that you are being properly reimbursed by payers who base their reimbursement on RBRVS. Includes all CPT® and HCPCS Level II codes with RVUs including gap values for those codes that are not valued by CMS. Detailed instructions provided for calculating total values and component values for each CPT code, including work, practice expense, and malpractice. Contains valuable payment rules for surgical assistants, multiple procedures, bilateral procedures, and co-surgeons.
- Complete list of all 2014 CPT® and HCPCS Level II codes including abbreviated descriptions with RVUs and other critical reimbursement data
- Gap fill code data (RVUs not provided by Medicare) are included to complete the reimbursement picture
- Detailed instructions for calculating locality specific fees using Geographic Practice Cost Indices (GPCIs)
- Instructions on comparing fees by payer to evaluate the reimbursement mix for your practice
- Step-by-step guidelines to help you determine your break even point for high-cost and/or high-volume services
- Modifier information helps you determine which modifier rules apply to each CPT and HCPS Level II code
- Professional component, technical component, and global RVUs provided for radiology and other services with separately billable professional and technical components
- Facility and non-facility totals are included, as well as work, practice expense and malpractice breakdowns for each CPT and HCPCS Level II code providing invaluable information for setting fees
- Preoperative, Intra-operative and Postoperative percentages help you determine appropriate payment when a physician provides only a portion of the global surgical service
- OPPS Cap RVUs and instructions for determining when these RVUs apply
- Review of recent legislation impacting the Medicare Physician Fee Schedule (MPFS) and reimbursement of physicians and nonphysician providers
CPT® is a registered trademark of the American Medical Association.
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