Question: What's your opinion about this response about whether physicians should be paid based on their billed RVUs? Why or why not? Do you agree or
What's your opinion about this response about whether physicians should be paid based on their billed RVUs? Why or why not? Do you agree or disagree? Why?
RVUs are used to calculate physician compensation by the Centers for Medicare & Medicaid Services (CMS) and private payers. This method measures the actual cost of services rendered depending on the extent of the physician's work, clinical and non-clinical resources, and expertise required to deliver the healthcare services. RVUs are determined by total RVUs, geographic practice cost indices (GPCIs), and conversion factor (CF). The total RVUs include three types of RVUs such as work RVUs, practice expense (PE) RVUs, and malpractice (MP) RVUs. As a result, physicians should not be paid directly based on their billed Relative value units (RVUs). In addition, each procedure or service differs in complexity, so t e RVUs differ. When a physician uses a CPT or HCPCS Level II code to submit for reimbursement, an RVU also is assigned. For example, CPT code 69209 is assigned to remove impacted ear wax unilateral with 0.47 total RVUs. For a more extensive procedure, CPT code 69220 cleaning out the mastoid cavity is assigned with 2.40 total RVUs, according to AAPC statistics, 2022. To calculate the final payment for physicians, the formula below is used
[(work RVU x work GPCI) + (PE RVU x PE GPCI) + (MP RVU x MP GPCI)] x CF = final payment
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