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HCFAs Physician Fee Schedule In 1992 HCFA initiated a new payment system known as the Resource-Based Relative Value Scale (RBRVS). The RBRVS includes three major components of resource costs that are required for physician services: physician work, practice expense, and the cost of professional liability insurance. The relative value established for each service is supposed to reflect the resources used in furnishing the service. As a "resource-based" relative value scale, the fee schedule does not reflect factors such as the value of a service to the patient.
The national uniform relative values for each of these components are then adjusted for each locality by geographic adjustment factors (GAF). As a result, Medicare providers are paid differently between each state and also within each state. New York, for example, has five separate payment localities due to the GAF. The law also establishes a Medicare volume performance standard that sets a target rate of increase for expenditures for Medicare physician services. Finally, each of the adjusted components are multiplied by an annual conversion factor that translates these values into reimbursement dollars.
Psychologists and the RBRVS |
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