Wiki RVU report for physician practice

[sandrasperrazza]

Our group would like a report that gives their total RVU's for a 3-month period for each physician, anyone have a simple way of acquiring this? Also, if we have a lot of procedures that are affected by the multiple procedure -51 modifier will this affect our totals?

 

[Pam Warren]

It's helpful if your billing software has the ability to capture the RVUs in your CPT database in relation to the specific CPT codes, so that when you run a charge report, you can report the RVUs at the same time.

The RVUs (by year) are available online in CMS's Physician Fee Schedule Lookup. You may have to do it manually, but they have the RVUs broken down by work, PE, and ME. Here's the link.

http://www.cms.gov/apps/physician-fee-schedule/license-agreement.aspx

Also, modifiers that affect payment should also affect RVUs. We actually have the ability to load CPT codes into our billing system in ways that identify the modifier usage and the impact on payment/work RVUs, so that we don't over-adjust, or overpay our providers based on RVUs they didn't earn. Payers disagree on the modifier reductions, but we calculate 150% for the -50. 50% for the -51, 16% for the -80, for example. You might have to contact your individual local payers to see what their standard fee reduction (or increase) is based on the modifiers.