Ophthalmology and Optometry Coding Alert

Question: How do I determine which RVUs to use in the Medicare fee schedule for reimbursement rates? Texas Subscriber Answer: The Physician Fee Schedule establishes different values for codes depending on the setting/site (facility or non-facility) in which the provider performs the service or procedure. For some services, the total RVUs for a given procedure are the same regardless of whether the physician performs the procedure in a facility. In some cases, however, the two totals may differ. How it works: The facility and non-facility totals are made up of several constituent parts: physician work RVUs (to cover the cost of the provider's "work"), practice expense RVUs (to cover the cost of supplies, equipment, etc.), and malpractice expense RVUs (to cover the cost of professional liability expenses). Physician work RVUs and malpractice expense RVUs are the same, regardless of the setting (facility or non-facility). Practice expense RVUs may vary by [...]