In medical billing claims are submitted to generate reimbursement and that reimbursement depends on relative value units.
What is an rvu in medicine.
Originally created as the principle unit of the rbrvs for cms rvus became the foundation of the medicare physician fee schedule mpfs as well as the basis of most commercial fee schedules.
The relative value unit serves as a means of determining the level of reimbursement that is awarded to a physician in exchange for services rendered.
Relative value units rvus january 12 2015 medicare uses a physician fee schedule to determine payments for over 7 500 physician services.
There are several factors that affect the amount that will actually be reimbursed.
Each provider determines how much it will charge for services provided but that is not necessarily the amount that will get paid.
Prior to the implementation of the rbrvs in 1992 physicians set charge rates for the medical care they provided to patients.
The cost of maintaining or operating a medical practice.
When a provider.
For example if the threshold is 300 rvus and a doctor gets 350 rvus a month he or she will receive 1894 5 50 rvus x 37 89 as the incentive.
A major medical procedure requires more skill and more time so it will generate a higher rvu.
When calculating a relative value unit rvu it s easy to become overwhelmed by the math.
These factors include rent costs in addition to the price of equipment and supplies.
These resources include the physician s work the expenses of the.
The sum of the three geographically weighted rvu values is then multiplied by the medicare conversion factor to obtain a final price.
Relative value units or rvus are the foundation of the criteria used to measure any type of medical services offered by physicians in the united states.
However if you can look beyond the calculations you ll find that the rvu is actually a good barometer of practice efficiency and patient complexity and it can provide helpful insights into performance says andy swanson vice president of consulting services at the medical group.
Historically a private group of 29 mostly specialist physicians the american medical association s specialty society relative value scale update committee ruc have largely determined medicare s rvu.
In wrvu compensation is based on the activity of a doctor.