Wiki RVUS ??? How do I better understand how to calculate?

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Kaitbohrer

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My outpatient orthopedic specialty office has asked me to help initiate raising prices on our office visits. The prices have been the same since I started billing & coding for them 4 years ago.

I need to learn more about how to calculate RVUS. I don't remember studying or being tested on RVU's in CPC or COSC credentialing. Help!
 
You don't need to calculate RVUs. RVUs are assigned to CPT codes. Many insurances follow the CMS model and pay a certain dollar amount per RVU to determine their fee schedule.
Since many insurances reimburse based on RVUs, and it's a good benchmark, many practices set their charges based on RVUs.
Whether your practice decides to charge $50 per RVU or $200 per RVU is a practice decision.
Your billing software may be able to help you through this process. For example, I did once manually input the RVUs for each code in our system (as a subspecialist, it was not every code. Anytime I wanted to update our fees, I was simply able to tell the system to charge $XX.XX per RVU, and update the fee schedule all at once.
I would just make sure that the office understands changing your fee will not result in higher insurance payments. Your contracted rate will not change unless you have the extremely unusual situation of a fee schedule based on your charge amount.
RVUs should be available on the CMS website. Most coding software will have them. Some versions of CPT books have them as well.
 
Kaitbohrer said:
My outpatient orthopedic specialty office has asked me to help initiate raising prices on our office visits. The prices have been the same since I started billing & coding for them 4 years ago.

I need to learn more about how to calculate RVUS. I don't remember studying or being tested on RVU's in CPC or COSC credentialing. Help!
Click to expand...
RVU'S ARE ASSIGNED. Are you asking how to calculate the payer modifiers?
 
SummerFlowers said:
My office is requesting RVU calculations for payroll . Would this be an example of Work RVU Calculations?
Click to expand...

My guess is your physicians have a contract where their reimbursement is tied in some way to RVUs (usually wRVUs). Payroll needs to know the information to calculate a bonus or something similar.
 
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