Resource-Based Relative Value Scale (RBRVS) is a schema used to determine how much money medical providers should be reimbursed (paid) for their services. It is partially used by Medicare and by nearly all Health Maintenance Organizations (HMOs). RBRVS are calculated for procedures performed by physicians or other medical providers by using adjustments for factors such as work load and expense variables and geographic/regional differences.

Generic Formula to use for this activity: Medicare Reimbursement = Total RVU x Conversation Factor

(Conversion Factor to be used is 34.023)

After reviewing the attached RBRVS review sheet, answer each of the following questions:

1. Given the RVUs below, please calculate the reimbursement for the following toxicology procedures:

RVU = 30, Therapeutic Drug Assays CPT 80152 Amitriptyline

RVU = 20, Therapeutic Drug Assays CPT 80158 Cyclosporine

RVU = 15, Therapeutic Drug Assays CPT 80184 Phenobarbital

NOTE: Be sure to include all steps of the calculation in your answer.

2. Aside from the adjustment made in the RVU for geographical region, what three other factors are used to determine prices? Describe some general examples for each factor.