Part B Insider (Multispecialty) Coding Alert

Gastroenterologists Stomach Massive Loss From PE-RVUs

The move to Practice Expense Relative Value Units created clear winners and losers among physician specialties, according to a new report by the Medicare Payment Advisory Commission.

Gastroenterologists' total payments dropped 4 percent as a result of PE-RVUs, and pathologists, radiologists and thoracic surgeons each lost 3 percent. Meanwhile, dermatologists gained a whopping 5 percent from the shift, which was phased in over four years starting in 1999.

But Medicare assignment rates didn't drop, and beneficiaries appeared to experience no serious problems in obtaining access to physician services, MedPAC notes.

In a second report, MedPAC said it was hard to tell whether the growth in volume of physician spending was improving the health of beneficiaries. While new technologies did add to the growth of physician spending, only 0.33 percent of total physician expenditures per year was associated with new codes. MedPAC said clear data on how new laws and regulations affected the growth in physician spending was hard to come by, because the Centers for Medicare & Medicaid Services needs more transparency.

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