decisionhealth Newsletters, Part B News - 2002 Issue 3 (March)
CMS: we won't ‘re-calibrate' relative values based on HER study
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Article Overview
This article explains CMS’s reaction to a Health Economics Research study examining how time assumptions factor into Medicare relative value calculations for physician services. It is relevant to coders, physician practices, and reimbursement professionals who follow CMS payment policy, RVUs, and AMA advisory processes. The article covers the study’s general findings, CMS’s stated reasons for not changing the system, and the involvement of AMA committees in reviewing the issue.
Why This Topic Matters
It provides context for how CMS views data used in setting physician payment values and why a study suggesting time overestimation does not necessarily lead to immediate reimbursement changes.
What You Will Learn
- How CMS responded to a study questioning physician time assumptions in Medicare payment methodology.
- Why CMS says it is not changing its relative value system based on the study.
- Which AMA groups were informed about the findings and their role in the discussion.
- What general types of physician service valuation issues the article addresses.
Who Should Read This
- Medical coders
- Physician office staff
- Compliance professionals
- Revenue cycle professionals
- Healthcare administrators
- Reimbursement analysts
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