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RVU-Time Factor

Leorah Posted Tue 29th of January, 2019 04:15:44 AM
We know that the physician work RVU is determined by the time and clinical skill necessary to treat a patient during an encounter. We are looking for the time factor used to make up the Physician Work RVU for the following codes 61624,36224, 36226,36245,758894,75736,76377 and 75898. We have a Supercoder subscription and were under the impression that we can see the RVU values for various codes but are unsure of the steps needed to perform in Supercoder to access the time factor. Please advise, Thank you.
SuperCoder Answered Wed 30th of January, 2019 06:21:09 AM

Hi Leorah,

 

Work RVU value (RVU values) are pre-defined by CMS. It is the value that is assigned to the code and it does not change on encounter to encounter basis. You can check RVU value / Work RVU value on SuperCoder. Here is the navigation. Enter a code like 61624 in SuperCoder search. It will navigate you to code detailed page. On the right side of the page, under compliance Tools, click on Fee Schedules. Scroll and you will get the Medicare Fee, Facility and Non Facility RVU values of CPT code 61624.

 

Also, find below the Work RVU value of the provided codes:

 

CPT code 61624 - 20.12

>CPT code 36224 - 6.25

CPT code 36226 - 6.25 

CPT code 36245 - 4.65

CPT code 75894 - 0.00

CPT code 75736 - 1.14

CPT code 76377 - 0.79

CPT code 75898 - 0.00

 

Hope, provided information would be helpful.

 

Thanks!      

Leorah Posted Thu 31st of January, 2019 04:53:19 AM
Yes, I saw those codes in Supercoder. My question is how that relates to time. What does 20.12 mean? How much time is allotted for that code? etc.
SuperCoder Answered Fri 01st of February, 2019 03:43:59 AM

Hi Leorah,

 

Time is not a factor in RVU calculation. There is a formula to calculate RVU (Non-Facility and Facility). A geographic practice cost index (GPCI) has been established for every Medicare payment locality for each of the three components of a procedure’s relative value unit (i.e., the RVUs for work, practice expense, and malpractice).  The GPCIs are applied in the calculation of a fee schedule payment amount by multiplying the RVU for each component times the GPCI for that component. 

 

The formula for 2019 Physician Fee Schedule Payment amount is as follows:

 

2019 Non-Facility Pricing Amount = [(Work RVU *  Work GPCI) +  (Non-Facility PE RVU * PE GPCI) +  (MP RVU * MP GPCI)] * Conversion Factor (CF)

 

2019 Facility Pricing Amount = [(Work RVU * Work GPCI) +  (Facility PE RVU * PE GPCI) +  (MP RVU * MP GPCI)] * Conversion Factor   

 

Hope, provided information would be helpful.

 

Thanks!

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