tci Medicare Compliance & Reimbursement - 2014 Issue 17
Reader Question: Know How RVUs Impact You
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Article Overview
This article explains the basics of Medicare physician fee schedule payment methodology, focusing on how relative value units are organized and why payment totals can differ by site of service and geographic locality. It is aimed at coders, billers, and reimbursement professionals who need a high-level understanding of fee calculation concepts, fee schedule lookup tools, and the general role of component-based payment adjustments.
Why This Topic Matters
Understanding RVUs helps coding and reimbursement staff interpret fee schedule values, compare site-of-service payment differences, and navigate Medicare and payer-specific lookup resources without relying on assumptions about a procedure’s payment level.
What You Will Learn
- How Medicare physician fee schedule values are organized at a high level
- Why payment totals can vary by setting and geographic locality
- How relative value unit components fit into fee calculation
- Where to find Medicare reimbursement information through lookup tools
- How payer-specific fee schedules may differ from Medicare methodology
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Practice managers
- Reimbursement specialists
Codes Discussed
Modifiers Discussed
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