Fee Schedules and Relative Value Units

Adding value to relative-value units.

R units (RVUs) were developed in 1988 as a method of accounting for physicians’ work effort and hospital or clinic expenses. Because RVUs provided a uniform, formulaic metric for myriad clinical services, they quickly became the prevailing method for setting feefor-service payments for Medicare and private insurance. However, the dominance of the fee-forservice model has created strong structur...

Technical Paper: Effectiveness of WC Fee Schedules

Development of a Model for the Validation of Work Relative Value Units for the Medicare Physician Fee Schedule.

The Centers for Medicare & Medicaid Services (CMS) uses the resource-based relative value scale to pay physicians and other practitioners for professional services. The work values measure the relative levels of professional time and intensity (physical effort, skills, and stress) associated with providing services. CMS asked RAND to develop a model to validate the work values using external da...

Medicare physician fee schedules: Issues and evidence from South Carolina

Three key research questions are identified and analyzed in this article. First is an investigation of whether Medicare already pays physicians using de facto fee schedules. Evidence from South Carolina suggests not. Second is an evaluation of the physician procedures and specialties likely to be affected by imposition of a Medicare fee schedule. Medical visits are identified as especially susc...

Comparing physician fee schedules in Canada and the United States

Although Canada and the United States have fundamentally different systems for financing health care, there are many similarities between the two countries in their approaches to physician payment. The similarities have increased recently with the adoption of the Medicare fee schedule. Canadian provinces have been using fee schedules for more than 20 years. This article provides an overview of ...