Understanding The Medicare Physician Fee Schedule ( For Physicians & Hospitals) - Part 1

Event Information
Product Format
Prerecorded Event
90 Minutes
Product Description

Get All You Need to Know About Medicare Physician Fee Schedule (MPFS) Rule

The final Medicare Physician Fee Schedule (MPFS) Rule updates payment policies as well as payment rates for services provided under the PFS. It involves modifications to the quality reporting initiatives related to the PFS— the Physician Quality Reporting System (PQRS), the Electronic Prescribing (eRx) Incentive Program along with the physician value-based payment modifier. Here are a few things that you must know:

  • How does the MPFS determine payments for physician professional services?
  • How do provider-based clinics affect physician payment under MPFS?
  • How does the MPFS accommodate CPT codes, HCPCS codes, and the various modifiers?
  • What is the global surgical package (GSP)?

Let our expert Duane C. Abbey answer all these questions to help you understand the provisions of Medicare Physician Fee Schedule. You get expert guidance on RBRVS, elements within the RBRVS, Relative Values, calculation of RBRVS payment, using RBRVS to establish charges, and much more.

Here are few highlights of the session:

  • Discuss the Resource Based Relative Value System (RBRVS) which provides the basis for the Medicare Physician Fee Schedule (MPFS).
  • Understand how hospitals become involved in and can utilize the Medicare physician fee schedule (MPFS).
  • Understand the facility versus non-facility aspects of RBRVS and the relationship to hospital-based clinics.
  • Understand the involvement of RBRVS with ASCs, CORFs, IDTFs, and CAHs.
  • Recognize sources of information from CMS concerning RBRVS and the Federal Register updating process.

Audio Conference Agenda:

  • Overview of RBRVS
    • Types of Health Care Payment Systems
    • Fee Schedule Payment Systems
    • Historical Development and Use of RBRVS
    • Types of Providers Covered by RBRVS
    • MPFS – Medicare Physician Fee Schedule
    • Locating and Downloading the RBRVS
  • Elements Within the RBRVS
    • RVUs
    • Special Indicators for Adjudication
    • Diagnostic Physician Supervision Levels
    • Other Information
  • Relative Values
    • Three Components for RVUs
    • Basis for Development of RVUs
    • Facility versus Non-Facility Practice Expense RVUs
  • Calculation of RBRVS Payment
    • Conversion Factor
    • Geographical Adjustments
    • Special Adjudication Rules
  • Using RBRVS To Establish Charges
    • Developing a Professional Fee Schedule
    • Developing Chargemaster Facility charges

Ask a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.

Prerequisites for Participating: General knowledge of healthcare payment systems, hospital services and physician services.

Who should attend? All personnel involved with physician coding, billing and claims filing. Personnel involved with provider-based clinics and establishing physician fee schedules. All hospital personnel involved with hospital services that are paid through or involved with RBRVS including CORFs, Physical/Occupational Therapy, ASCs, CAHs and IDTFs. Personnel who need to have a better understanding of the physician payment process under the Medicare program. Chargemaster, coordinators, cost accounting personnel, compliance personnel, physician and clinic directors, non-physician practitioners, clinic network administrators.

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About Our Speaker

Duane Abbey Hospital Coding & Compliance Expert

 Duane C. Abbey, Ph.D. is a management consultant and president of Abbey & Abbey, Consultants, Inc., which specializes in healthcare consulting and related areas. Duane earned his graduate degrees at the University of Notre Dame and Iowa State University and has more than 20 years of experience as a consultant. He performs various types of financial analysis involving business structuring, organizational development, enrolment and other financially related concerns of organizations....   More Info
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