ED Coding & Reimbursement Alert - 2014 Issue 25
Reader Question: Know How RVUs Impact You
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Article Overview
This article explains the basics of relative value units (RVUs) within the Medicare Physician Fee Schedule and how site of service and geographic factors affect fee calculation. It is aimed at coders, billers, and other revenue cycle professionals who need a general understanding of Medicare payment methodology and where to find fee information. The discussion also mentions online fee lookup resources and a site-of-service breakdown relevant to outpatient evaluation and management services.
Why This Topic Matters
Understanding RVUs helps coding and billing professionals interpret how Medicare payment amounts are derived and why the same service may yield different fees depending on setting and locality. This matters for charge setting, reimbursement review, and general fee schedule research.
What You Will Learn
- The basic structure of RVUs in the Medicare Physician Fee Schedule
- How site of service can affect total RVUs
- How geographic adjustments are applied in Medicare payment calculations
- Where to look up Medicare fee schedule information online
- How fee lookup tools may present facility and non-facility payment details
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Practice managers
- Physician office staff
Codes Discussed
Modifiers Discussed
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