CMS Fee Schedule Does Not Favor Procedures

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CMS Fee Schedule Does Not Favor Procedures
CMS Fee Schedule Does Not Favor Procedures

(HealthDay News) — The Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule does not systematically provide higher valuation of physician work per unit time for procedure/test codes than for evaluation and management (E/M) codes, according to a study published in the Annals of Surgery.

Kevin A. Kerber, MD, from the University of Michigan Health System in Ann Arbor, and colleagues evaluated data regarding relative value units (RVUs), physician work times (minutes) and claims for all active level I Current Procedural Terminology (CPT) codes (6,522 CPT codes: 87 E/M codes and 6,435 procedure/test codes) from 2011 CMS files.

Procedure/test codes did not have a significant difference in work RVUs adjusting for time (−0.631; 95% CI, −1.427 to 0.166), compared with E/M codes, the researchers found. 

When adjusting for time, there was not a work RVU advantage specifically for surgical CPT codes compared with E/M (−0.760; 95% CI, −1.560 to 0.040). 

After weighting codes by the number of claims, the results were similar, indicating that an increase in RVUs per minute was not concentrated in a small number of highly utilized procedure codes.

"We did not find evidence of a systematic higher valuation of physician work in procedure/test codes than in E/M codes in the CMS RVU system," the researchers wrote.

Several authors are involved with the RVS Update Committee.

Reference

  1. Kerber KA et al. Ann Surg. 2014;doi:10.1097/SLA.0000000000000990.
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