Resource Based Relative Value Scale (RBRVS)
The Center for Medicare and Medicaid Services (CMS, formerly HCFA) assigns each medical procedure a:
1) relative value reflecting the physician work involved in the service (work RVU),
2) relative value reflecting the practice expense generated by the procedure (practice expense RVU), and
3) relative value representing the cost of professional liability needed to provide the service (professional liability RVU)
Physician Payment by Medicare – RBRVS, RVU
Relative value unit RVU – determines how much is paid for any service based on 3 factors:
Physician Work RVU – physician time & intensity
+ Practice Expense RVU – based on overhead
+ Malpractice cost RVU – cost of liability insurance
= Total RVU X Conversion Factor = Payment
ICD, CPT, RBRVS, RVU, GPCI
• ICD – International Classification of Diseases
• CPT – Current Procedural Terminology
• RBRVS – Resource Based Relative Value Scale
• RVU – Relative Value Unit
• GPCI – Geographic Practice Cost Index
