A key element in the construction of a physician fee schedule is the underlying relative value scale (RVS). The focus in this article is on the development and comparison of RVS's based on alternative data sources and construction methods. Results suggest that medical procedures' values are preserved across alternative charge-based RVS's. Some differences are observed, however, when comparing p...

BACKGROUND The Texas Medicaid Program (Medicaid) defines billable time for labor analgesia as face-to-face time; therefore, anesthesia providers determine billed time. The authors' goal was to determine the influence of anesthesia providers on labor analgesia costs billed to Medicaid. METHODS Under the Freedom of Information Act, Medicaid provided data on claims paid for 6 months in 2001 for ...

The Health Care Financing Administration is in the process of designing a competitive bidding model for the purchase of outpatient clinical laboratory services. One segment of this process involves the development of a relative value scale (RVS). The RVS could be used as part of the bidding process and as the basis of payment. The RVS could also be used as the basis of a national fee schedule, ...

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 ...

The Centers for Medicare and Medicaid Services (CMS) released the proposed 2017 Medicare physician fee schedule on July 7, 2016, addressing Medicare payments for physicians providing services either in an office or facility setting, which also includes payments for office expenses and quality provisions for physicians. This proposed rule occurs in the context of numerous policy changes, most no...

MR. WILLIAM J. LONDON: I am an actuary with the Health Care Financing Administration (HCFA), and we also have Richard Swift from Aetna, and Woody McDonald from Tillinghast. We're going to discuss the Medicare physician fee schedule and the Medicare volume performance standards, which are the expenditure targets for Medicare, and alsothe other part of physician payment reform or balance billing ...

This major final rule with comment period addresses changes to the physician fee schedule, and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute.

This final rule implements requirements of section 216 of the Protecting Access to Medicare Act of 2014 (PAMA), which significantly revises the Medicare payment system for clinical diagnostic laboratory tests. This final rule also announces an implementation date of January 1, 2018 for the private payor rate-based fee schedule required by PAMA.