CMS publishes updated total RVUs in final rule addendum

Although the Centers for Medicare & Medicaid Services (CMS) establishes policies and payment decisions in the annual Medicare Physician Fee Schedule (PFS) final rule, the final total relative value units (RVUs) for individual Current Procedural Terminology (CPT) codes are published separately in the PFS addenda that accompany the rule.

A code’s total RVUs reflect the resources associated with providing the service and are generally made up of three components:

• Physician work RVUs, which account for the time, skill, effort, and clinical judgment required, if applicable.
• Practice expense (PE) RVUs, which account for clinical staff, equipment, supplies, and other costs of maintaining a medical practice.
• Professional liability insurance (PLI), or malpractice, RVUs, which reflect the relative liability costs associated with the service.

The final total RVUs for the new unattended sleep testing codes have been updated according to the published addendum.

View the addendum here and stay tuned for the full analysis of the PFS final rule.

Members may send questions to coding@aasm.org.