wRVUs and CMS changes

[Sparky]

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

[Random1]

[Sparky]

exactly....

[StarTrekDoc]

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

[childay]

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

[CordMcNally]

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

Administrators. Ok, just kidding.

[Random1]

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.

[ENT Doc]

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

The conversion factor. By 10.2% I think.

[ENT Doc]

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.

[CM]

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.

[Random1]

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 ?

[Tim]

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.

[Random1]

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.

[DrSam]

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?

[ENT Doc]

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.