By Marti Cox, MLIS, Content Manager
MGMA Information Center
Note: A big benefit of MGMA membership is immediate access to our information gurus in the MGMA Information Center. It's their job to find the knowledge that healthcare leaders need to manage their practices. Here, we answer common questions from our members.
Relative value units (RVUs) – the standardized value associated with the services your medical practice provides – are adjusted every year in the Medicare Physician Fee Schedule, which I blogged about yesterday. In this post, I'm tackling questions from MGMA members about how RVUs work, and where to find the most recent values and benchmarks for your medical practice specialty.
Q. I'm new to RVUs ... how do they work?
A. Because this is such a big topic for medical practices, we've created a Web page dedicated to RVUs. See the section titled, "Getting Started with RVUs," for links to articles that cover the basics. Bottom line: RVUs are an important building block of reimbursement. Each CPT* code has an RVU that helps determine its reimbursement value.
Also, take a look at the bestselling book from MGMA, RVUs: Application for Medical Practice Success. It provides a thorough introduction to RVUs, with chapters on productivity measures, RVU cost analysis, RVUs in managed care contracting, provider compensation and benchmarking.
Or, simply search the MGMA Web site using the terms RVUs or "relative value units."
Q. Where can I find the most current RVU values by CPT code?
A. These values are printed in the text of the 2010 Medicare Physician Fee Schedule; however, on its website, CMS also provides links to download the relative value files from 2003 to today.
Follow the steps below to find and download the folders and files you can use with your spreadsheet or database software (Note: Folder includes files in .xls, .csv and .txt formats):
- In the left-hand navigation menu on the fee schedule page, select the link PFS Relative Value Files.
- On this page, you'll see a listing of zipped folders for each year. Click the years to find the most recent (last) file listed for the particular year. Currently, the most recent folder is titled: RVU10AR on page 4. These files are updated throughout the year, so check back regularly.
- After you complete the download and unzip the file, be sure to locate the readme PDF that explains the folder contents and provides detailed instructions. (Note: The folder includes GPCI** and anesthesia files in addition to the relative value scale files.)
- To see the most recent relative value scale, select the Excel file titled: pprrvu10.xls. Open the file and "unfreeze" the panes to see the entire spreadsheet. The CPT/HCPCS*** codes are listed in the far left-hand column, while the corresponding payment categories are listed across the top row. Once you identify a code in the left-hand column, scroll across the corresponding row to see the rate listed for that code under the payment category identified in the selected column heading.
Q. Where can I find RVU benchmarks for my practice's specialty?
A. MGMA collects and reports this information in its annual MGMA survey reports.
The MGMA Physician Compensation and Production Survey Report provides both total and work RVUs by specialty, group type and ownership. It also provides ratios for compensation, collections and encounters.
The MGMA Cost Survey Reports include ratios for staffing, charges, revenue, cost and productivity per total RVUs and work RVUs. Choose from the following two reports:
- Cost Survey for Multispecialty Practices: 2009 Report Based on 2008 Data
- Cost Survey for Single-Specialty Practices: 2009 Report Based on 2008 Data
Please contact the Information Center at 877.275.6462, ext. 1887 for further assistance with any of the above resources.