England Finance

Sep 30 2017

Medicare Physician Payment Schedule #physician #reimbursement #systems


#

  • Creating the Medical School of the Future

See how the AMA works with schools to prepare for the future.

  • Continuing Medical Education

    Sharpen your knowledge and build essential skills to succeed in practice.

  • Financing Medical School

    Learn about scholarship opportunities available to help lower the cost of medical school.

  • Becoming a Physician

    Find out how the AMA is working to increase funding for GME positions and helping recent graduates prepare for licensing exams.

    Access exclusive physician-focused insurance plans with reduced rates and valuable lifestyle offers and services.

  • Residency & Career Planning

    Find resources for a range of medical career options, whether you are just starting, continuing or restarting a medical career.

  • International Medical Graduates

    Learn what is necessary for those educated abroad to begin a medical career in the United States.

    Find resources to help physicians apply their skills to different roles or to re-enter a medical practice.

    Read the AMA s leading peer-reviewed journals on health care research and topics, or subscribe to our email newsletters for up-to-date medical news.

  • Physician Data Privacy

    See how the AMA protects physicians’ privacy in its Physician Masterfile database, especially in terms of personal information and prescribing data.

    Find out how the AMA is working to enhance the delivery of care and enable physicians and health teams to partner with patients to achieve better health.

    Learn how the House of Delegates, councils, member groups, states medical associations and specialty societies, and staff promote patient health.

    The AMA is leading meaningful innovation to enable a better health care system for patients, physicians and the country.

    Best Match

    Top searches

    Popular searches

    Medicare Physician Payment Schedules

    The Social Security Act (the Act) requires the Centers for Medicare Medicaid Services (CMS) to establish payments under the Medicare Physician Payment Schedule based on national uniform relative value units (RVUs) that account for the relative resources used in furnishing a service. The Act requires that RVUs be established for 3 categories of resources:

    • Physician work
    • Practice expense (PE)
    • Malpractice (MP) expense

    CMS is also required to establish by regulation each year’s payment amounts for all physician services paid under the Medicare Physician Payment Schedule, incorporating geographic adjustments to reflect the variations in the costs of furnishing services in different geographic areas.

    The Medicare Physician Payment Schedule’s impact on a physician’s Medicare payments is primarily a function of 3 key factors:

    Calculating the Payment Schedule

    The Omnibus Budget Reconciliation Act of 1989 (OBRA 89) geographic adjustment provision requires all 3 components of the relative value for a service—physician work relative value units (RVUs), practice expense RVUs and professional liability insurance (PLI) RVUs—to be adjusted by the corresponding GPCI for the locality. In effect, this provision increases the number of components in the payment schedule from 3 to the following 6:

    • Physician work RVUs
    • Physician work GPCI
    • Practice expense RVUs
    • Practice expense GPCI
    • PLI RVUs
    • PLI GPCI

    The formula for calculating payment schedule amounts entails adjusting RVUs, which correspond to services, by the GPCIs, which correspond to payment localities.


  • Written by admin


    Leave a Reply

    Your email address will not be published. Required fields are marked *