New RVUs boost surgery, cut cardiology, radiology

Final values coming Nov. 1

Medicare has released its proposed changes in the relative value units (RVUs) that will be used to set next year’s revised physician fee schedule for various services. If you’re a surgeon, there is good news: Surgery specialties tend to get the biggest boost in total payments from the reconfigured RVUs this time around.

But, there is a "but." The word from government number-crunchers is that newly revised physician work time data will reduce the final practice expense RVUs for many of the services performed by cardiac and thoracic surgeons. This means while they are still likely to see a rise in their RVU base for 2002, it probably won’t be as generous as initially proposed.

For cardiologists and radiologists, the bad news is they will probably see a cut in their Medicare fees as a result of the RVU review. By law, Medicare must perform a review of the work RVUs used to set payments for physicians’ services at least every five years. This is the second review of work RVUs since the fee schedule was implemented in 1992. The final work RVUs are expected to be published Nov. 1, effective for physician services furnished starting Jan. 1, 2002.

Work on this second five-year review went into full swing with publication of a proposed rule in the Federal Register on July 17, 2000. Since then, Medicare has received comments from over 30 specialty groups and organizations involving more than 900 CPT and HCPCS codes.

Specialty societies give input

A key player in this review process is the American Medical Association’s Specialty Society Relative Value Update Committee (RUC). The RUC is supported by the RUC Advisory Committee, which is made up of representatives of 100 specialty societies in the AMA’s House of Delegates.

The RUC recommends RVU levels for new and revised CPT codes to Medicare, which can accept, reject, or revise these recommendations. For this review, Medicare received RVU recommendations from the RUC for all codes being analyzed, except anesthesia and conscious sedation-related codes.

For codes used only by nonphysician practitioners, the Health Care Professionals Advisory Committee, a companion to the RUC, has made recommendations to Medicare. (For a review of code recommendations by specialty area, see the Physician’s Coding Strategist articles in this month’s issue.)