tci General Surgery Coding Alert - 2019 Issue 3

Reader Question: Spotlight CF: 1 Factor for Medicare Fees

Question:  What is the “conversion factor,” and how does it impact Medicare payment? Nebraska Subscriber Answer: The conversion factor (CF) is a numerical multiplier used to calculate payment rates for the Medicare Physician Fee Schedule (MPFS). CMS adjusts the CF each year using a formula that considers factors such as a medical economic index, budget neutrality, and legislative changes to healthcare coverage. The primary factor used to determine the payment rate for any medical procedure is the Relative Value Units (RVUs) assigned to that procedure. RVUs are based on a resource-based relative value scale (RBRVS) that...

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