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Practice Enhancement
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TCEP Practice Enhancement

This section includes information from the non medical aspects of emergency practice including billing, management, recruiting, liability insurance, contracting, group governance, quality improvement, work environment and workforce issues.

EMphasis Article

Zachary Goldman, MD

This bulletin is an update on the change in RVUs from 2013 to 2014.   
The recent signing of the Pathway for SGR (sustainable growth rate) Reform Act of 2013 prevented the scheduled 24% SGR Medicare physician payment reduction from taking effect on January 1, 2014. There was about a 5% increase in the converstion factor for 2014. Many providers are not aware of how total RVUs are calculated and then how that number is used to determine payment. Below you will find the equaiton to calculate total RVUs, a table with 2014 RVU values for 99281-99291 (critcal care), and finally a table comapring 2013 and 2014 payment. With this information we can look to calulate RVUs and payment for these RVUs. Overall the information shows that while there was about a 2% decrease in 2014 total RVU value secondary to decrease Practice Expense number the conversion factor was increased following Budget neutrality leading to and overall 2% increase in payment for these EM levels.

2014 MPFS (Medicare Physician Fee Schedule) Conversion factor is: $35.8228

2013 MFPS Conversion factor was:  $34.02

[(Work RVUs x Work GPCI) + (Practice Expense RVUs x Practice Expense GPCI) +(Malpractice RVUs x Malpractice GPCI)] = Total RVU

Total RVU x Conversion Factor = Medicare Allowable Payment

 



**Special thanks to the ACEP Billing and coding Conference for the above tables**

List of Reportable Illnesses, Injuries, and
Events for Texas Physicians

SeveralTexas laws (Health & Safety Code, Chapters 81, 84 and 87) require specific information regarding notifiable conditions be provided to the Texas Department of State Health Services (DSHS). Health care providers, hospitals, laboratories, schools, and others are required to report patients who are suspected of having a notifiable condition (Chapter 97, Title 25, Texas Administrative Code). To view the report CLICK HERE

 

 

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