Wiki RBRVS questions

[kgarcia1]

Hello, Can anyone tell me the difference between global/ non-facility and facility? Also, can anyone suggest a resource for learning more about RBRVS? I would appreciate ANY feedback I can get. :0) Kelly G. (new to the coding world!)

 

[jbaird]

This will depend on what type of provider you work for. The physician RVU file can be found at:
http://www.cms.gov/PhysicianFeeSche...=ascending&itemID=CMS1230197&intNumPerPage=10
If you download the full RVU file you will get a folder full of information. Take a look at the acrobat file which explains what each column means. The bottom PPRRVU10 file is the one you'll want to open. The excel worksheet, not the comma separated file.

I work in radiology, so to me global is when the doctor owns/operates the office, equipment, pays the employees and reads the exam. The technical portion is just for the use of the equipment and staff. The professional portion is billed for the radiologist or physician reading the study. If a radiologist is reading x-rays for a hospital then the hospital would bill the CPT with a TC modifier attached and the radiologist would bill the CPT with a 26 modifier attached. If the radiologist owns his/her own office the study would be billed without a modifier and this would be global billing. Non-facility is the physician's office. Facility is the hospital.

If you are not billing for a physician you'll need to start here to look up the correct RVU file:
http://www.cms.gov/home/medicare.asp
Look under the fee for service section on the right.