Examples of RVU in a sentence
These payment rules include, but are not limited to, the following:• Manuals and Relative Value Unit (RVU) files published by the Centers for Medicare & Medicaid Services (CMS), including:o National Correct Coding Initiative (NCCI) edits, including procedure-to-procedure (PTP) bundling edits and Medically Unlikely Edits (MUE).
For example, a procedure that has a RVU value of 2.0 would typically require twice the resources of a different procedure that has a RVU value of 1.0. The RVU values are adjusted annually by the AMA based on annual reviews and recommendations of experts in each medical specialty.Conversion Factors are decided upon by each provider agency based on its specific cost structure.
The base facility fee is calculated as follows: Non-Facility Site of Service Practice Expense (PE) Relative Value Unit (RVU) * Statewide Geographic Adjustment Factor (GAF) for PE * RBRVS Conversion Factor (CF) = Base facility fee.
Fees for Behavioral Health Services are determined using the conversion factor of $53.15 x RVU for each procedure as explained above.
For each of the 23 CPT/HCPCS code groups, representative CPT/ HCPCS codes are statistically selected and weighted so as to give a weighted average RVU comparable to the weighted average RVU of the entire CPT/HCPCS code group (the selected CPT/HCPCS codes are set forth in the Milliman USA, Inc., Health Cost Guide- lines fee survey); see paragraph (a)(3) of this section for Data Sources.
For example, a procedure that has a RVU value of 2.0 would typically require twice the resources of a different procedure that has a RVU value of 1.0. The RVU values are adjusted annually by the AMA based on annual reviews and recommendations of experts in each medical specialty.
Using the nationwide 80th percentile charges for the selected CPT/HCPCS codes from paragraph (f)(3) of this sec- tion, a nationwide conversion factor is calculated for each of the 23 CPT/ HCPCS code groups by dividing the weighted average charge by the weight- ed average RVU.
Again, the base rate for each category of ground ambulance services is the CF multiplied by the applicable RVU.
The resulting nation- wide total RVUs are multiplied by the geographic area adjustment factors de- termined pursuant to paragraph (f)(2)(iv) of this section to obtain the area-specific total RVUs.(iv) RVU geographic area adjustment factors for CPT/HCPCS codes that do not have Medicare RVUs, including codes that are designated as unlisted proce- dures.
A mathematical approximation method- ology based on least squares techniques is applied to the RVUs specified for each of the groups set forth in para- graph (l)(2)(i) of this section, yielding two charge amounts for each HCPCS code group: a charge amount per incre- mental RVU, and a fixed charge amount.