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wRVUs and CMS changes

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  • wRVUs and CMS changes

    For those that are employed base model with wRVU base or threshold and then wRVU bonus provision, have you heard about any changes to contracts and base/bonus levels from your admins?

    Starting Jan 1st with CMS coding and wRVU changes, significant 7-12% increase in wRVU for Est 99203-99205 and 28-45% increase for New pt 99212-99215 patients.
    Assuming relatively same mix of 3,4, 5's expect to have a fair amount of wRVU inflation for similar work performed/patients seen/work and vacation days etc

    just curious

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    • #3
      exactly....

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      • #4
        Not only that but time based calculations are being redefined. We're looking at huge 99214 and 99215 increases at our academic center.

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        • #5
          So who did the RUC cut to pay for these increases?

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          • #6
            Originally posted by childay View Post
            So who did the RUC cut to pay for these increases?
            Administrators. Ok, just kidding.

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            • #7
              I think the RVU conversion factor went down, so if you are self employed , the changes look to be negative. But if you are employed and have a set rate for wRVUs looks like a net gain unless your institution lowers your conversion factor on a local level.

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              • #8
                Originally posted by childay View Post
                So who did the RUC cut to pay for these increases?
                The conversion factor. By 10.2% I think.

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                • #9
                  Originally posted by Sparky View Post
                  For those that are employed base model with wRVU base or threshold and then wRVU bonus provision, have you heard about any changes to contracts and base/bonus levels from your admins?

                  Starting Jan 1st with CMS coding and wRVU changes, significant 7-12% increase in wRVU for Est 99203-99205 and 28-45% increase for New pt 99212-99215 patients.
                  Assuming relatively same mix of 3,4, 5's expect to have a fair amount of wRVU inflation for similar work performed/patients seen/work and vacation days etc

                  just curious
                  I’m sure the hospital employment contract specifies how the specific conversion factor they use is changed on a yearly basis or otherwise. Surely, they cannot sustain those payments if they do not have the capacity to adjust their conversion factors. Look at your contract.

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                  • #10
                    Originally posted by Random1 View Post
                    I think the RVU conversion factor went down, so if you are self employed , the changes look to be negative. But if you are employed and have a set rate for wRVUs looks like a net gain unless your institution lowers your conversion factor on a local level.
                    Not necessarily negative, but not much net change for a private practice or for the hospital that employs physicians, at least according to physician running this site: https://www.emuniversity.com/.
                    (I purchased his course.)

                    However, it looks like the changes will result in lower average coding levels from me, so I think my wRVUs might decrease.
                    Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried (many) bags for a lovely and gracious 59 yo Cyd Charisse. (RIP) Hosted epic company parties after Friday night rehearsals.

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                    • #11
                      However, it looks like the changes will result in lower average coding levels from me, so I think my wRVUs might decrease.

                      Why would your CPT code level change because of this ?

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                      • #12
                        Interesting scenario here.
                        Change the wrvu’s and the conversion factors.

                        The concept of evening it out seems “politically wise”, but some will win and some will lose.
                        I doubt it is the large organizations.

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                        • #13
                          I think what they did was increase RVU formula for E&M codes, decrease RVUs for procedures and lower the conversion factor making it budget neutral in the end. I think you could call this smoke and mirrors, But it looks like those who generate more E&M codes than procedure cpt codes will fair better. But I guess we will see.

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                          • #14
                            Originally posted by CM View Post

                            Not necessarily negative, but not much net change for a private practice or for the hospital that employs physicians, at least according to physician running this site: https://www.emuniversity.com/.
                            (I purchased his course.)

                            However, it looks like the changes will result in lower average coding levels from me, so I think my wRVUs might decrease.
                            I've frequented the free portion of his site for years when looking up the specific criteria for a particular E&M code. Which specific course did you purchase? Worth it? Pros/cons?

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                            • #15
                              Originally posted by CM View Post

                              Not necessarily negative, but not much net change for a private practice or for the hospital that employs physicians, at least according to physician running this site: https://www.emuniversity.com/.
                              (I purchased his course.)

                              However, it looks like the changes will result in lower average coding levels from me, so I think my wRVUs might decrease.
                              CMS ran projections for each specialty. Take a look to see if you'll likely end up net negative or positive. This largely benefits primary care and more clinic based specialties. Cards may have gotten hit. Rads got pummeled.

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