{"id":2968,"date":"2013-09-20T09:12:53","date_gmt":"2013-09-20T09:12:53","guid":{"rendered":"http:\/\/www.medicalbillersandcodersblog.com\/?p=2968"},"modified":"2025-05-22T08:24:24","modified_gmt":"2025-05-22T08:24:24","slug":"utilizing-the-medicare-physician-fee-schedule-accurately-to-increase-revenue","status":"publish","type":"post","link":"https:\/\/www.medicalbillersandcoders.com\/blog\/utilizing-the-medicare-physician-fee-schedule-accurately-to-increase-revenue\/","title":{"rendered":"Utilizing the Medicare Physician Fee Schedule Accurately\u00a0to Increase Revenue"},"content":{"rendered":"

The Physician Fee Schedule contains valuable information regarding reimbursement and coding for Medicare patients. The Schedule was implemented in January 1992 before which service charges revolved around reasonable and prevailing charges.<\/p>\n

After the implementation of the schedule, the basis of charging for the services has shifted towards the resource costs that are incurred in providing a specific service. Payment indicators acquired from the schedule are used by many commercial payers in processing claims.<\/p>\n

RVUs and its importance to physicians<\/strong><\/h2>\n

Relative Value Unit, known in short as RVU, is a value measuring formula which is used by the Medicare program in the United States. This formula is put into use for calculating physicians\u2019 compensations as well as other bonuses. Prior to the use of RVUs, there was great payment variability for physician services.<\/p>\n

The aim of RVU is to remove these variables from the equation, thereby ensuring proper payment. RVUs hold great importance because they determine how much a physician will be paid for a particular service.<\/p>\n

Centers for Medicare and Medicaid Services (CMS) assign three values; practice expense RVUs, Work RVUs, and Malpractice expense RVUs, to Current Procedural Terminology (CPT) codes.<\/p>\n

CPT codes are nothing but numbers which are assigned to services that are provided to patients by physicians. Physician work is measured most of the time using the Work RVUs.<\/p>\n

The Release of PFS, and accessing it<\/strong><\/h2>\n

The Physician Fee Schedule gets released in the form of a draft every year under the Proposed Physician Rule and gets finalized in the final rule, which generally happens every October.<\/p>\n

The PFS can be accessed by medical practices for free at the CMS website. The online search function of the PFS also allows physicians and practices to look up individual codes.<\/p>\n

The Significance of the PFS<\/strong><\/h2>\n

The Physician Fee Schedule provides the following information:<\/p>\n