What Is the RUC and How Does it Impact Gastroenterology?

Abstract

provision of each service. 7 The Medicare RBRVS physician fee schedule is derived from the “relative value” of services provided and based on the resources consumed. The relative value unit (RVU) of a service is based on 3 components: the physician work to perform the service, the practice expense associated with the service, and the professional liability expense for the provision of the service. The physician work component is the most complex, as it must account for 4 categories of input: time, mental effort and judgment, technical skill, and psychological stress (or the time and intensity involved in providing a medical service). 9 A payment for a procedure depends on its assigned RVUs and the input prices assessed for each RVU component. Under mandates in Section 1848(e) of the Social Security Act,theCentersforMedicareandMedicaidServices(CMS) must apply geographic practice cost indices (GPCI) in the calculationofcomponentRVU inputprices, whichmustbe updated at least every three years. Each component is then adjusted to account for area price differences under the GPCI before the 3 components are summed and multiplied by the conversion factor to arrive at an appropriate reimbursement per service rendered.