My primary care doctor mentioned the importance of the Medicare fee schedule in gauging cost and competitiveness of medical services and products. Can someone expound on the subject more?
I can give you an example of how the Medicare fee schedule works. Say, you have Medicare and you went for an outpatient visit (code 99213) in New Jersey. The RVU of that code in NJ is 1.57. Using the 2005 RBRVS and the Conversion Factor of $37.90, Medicare will have to pay $59.50 for each code 99213 performed. The Medicare fee schedule is also beneficial to hospitals and physicians. Most for-profit hospitals need to track how much of their income is lost. With the fee schedule, they can gauge if certain medical procedures’ costs should be adjusted to recoup potential losses. A physician considering taking a job in two hospitals could also compare the competitiveness of each hospital by checking the fee data. Hospitals charge differently, so the physician would want to take the job at the hospital that can provide him with a better financial standing. The Medicare fee schedule is updated several times to consider changes in the rates of medical services. Answer by general public - June 26, 2009 @ 9:49 am No CommentsNo comments yet. Leave a comment |
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The Medicare fee schedule is a system that Medicare uses to determine how much money should be paid to medical providers. The Medicare fee schedule is based on the Resource-Based Relative Value Scale. RBRVS is a schema that assigns a relative value to a procedure that a medical provider or a physician performs. This relative value is adjusted by geographic region to compensate for the different medical costs in different states.
