2025 Coding Guide-5: Resource-based Relative Value Scale (RBRVS)

5: Resource-based Relative Value Scale (RBRVS)

Pdf Summary

The document provides information on the Resource-based Relative Value Scale (RBRVS) and its use in determining Medicare reimbursements for physician services. The RBRVS payment schedule consists of three elements: relative value units (RVUs) for each service, geographic adjustment factors, and a national conversion factor. The formula for calculating Medicare payment amounts is provided, with an example calculation for a nerve conduction test in Minnesota.<br /><br />The document also explains Geographic Practice Cost Indices (GPCI), which are used alongside RVUs to adjust reimbursement rates for regional and practice-specific factors. It provides a table of GPCI values by state and locality for 2022.<br /><br />Additionally, the document includes a comparison of RVUs and reimbursement rates for nerve conduction studies (NCS) and needle electromyography (EMG) procedures between 2022 and 2023. It lists the CPT codes, descriptions, and RVUs for each procedure, showing the changes in RVUs and reimbursement rates between the years.<br /><br />For a more detailed comparison of the Physician Fee Schedule for commonly used procedures in electrodiagnostic and neuromuscular medicine, the document refers readers to AANEM's member-only Coding Resource page.

Keywords

Resource-based Relative Value Scale

Medicare reimbursements

relative value units

geographic adjustment factors

national conversion factor

Geographic Practice Cost Indices

nerve conduction test

needle electromyography

CPT codes

AANEM Coding Resource