How to Determine RVU

Health care providers bill their services using current procedural terminology, or CPT, codes. The American Medical Association developed these codes to provide consistent terminology to describe different medical procedures that are performed. The resource based relative value system or RBRVS, also called relative value units or RVUs, represent the monetary value that the Centers for Medicare & Medicaid Services has assigned to each CPT code. RVUs for each CPT are reviewed at least every five years. RVUs do not guarantee a reimbursement amount for a service; however, they can be used when determining fees for service in private practice. Several different factors affect the number of RVUs assigned to a particular CPT code.

Things You'll Need

• Center for Medicare & Medicaid Services physician fee schedule

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Instructions

• 1

  Refer to the CMS fee schedule to obtain the physician work RVU, which accounts for the amount of time, skill, intensity of work and training that is required for a specific procedure, or CPT code, to be completed.

• 2

  Refer to the CMS manual to obtain the practice expense RVU, which includes rent, supplies, utilities and support staff required for each CPT procedure. This RVU also includes indirect costs associated with patient treatment -- like maintaining a waiting room and paying for billing services.

• 3

  Refer to the CMS manual to obtain the malpractice RVU -- costs related to professional liability expenses associated with the particular medical procedure.

• 4

  Use Medicare's geographic practice cost index, or GPCI, to obtain the expense value for each of the RUVs in relation to the location of your medical practice. This number will increase RUVs in areas with higher cost of living and decrease in less expensive areas. The RVUs and GPCIs combined will cause reimbursement rates to increase or decrease.