- Joined
- Apr 3, 2013
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I received some education about RVUs and am relatively knowledgeable with CPT codes and billing and such, but I'm wondering what types of RVUs are typically included into a standard RVU-based physician compensation package. For example, we bill for nurse visits and Medicare's Chronic Care Management here, but those are not included on my monthly reports and I feel they should be. I have a meeting scheduled with my employer to review these questions further, but I'm hoping someone can point me in the right direction for further resources on the matter so I go in equipped. FYI I work Mon-Thu only, except when on for hospitalist or newborns and that is only a quick 2-3 hr hospital trip early in the morning.
OUTPATIENT
All the standard office visit types are there per usual (New/Established, Consults, TCM, Preventive visits, Medicare AWV, School/Sports Physicals, etc.). Examples of non-office visit related RVUs generated on my list include:
INPATIENT
I also do hospitalist shifts and get paid hourly for that (2hr base pay regardless plus $/hr for any additional hours that are reported). Sometimes Hospital Care Initial/Discharge and Observation Care shows up on my monthly reports, but it seems very inconsistent with reality and makes me question where they are pulling the data. On the other hand I do get paid hourly so I feel like any RVUs showing up is like double dipping to me (paid hourly + paid for RVU generation)... I almost hesitate to even bring this up for that reason.
L&D
I also see newborns in the hospital and do circumcisions. We get paid a weekly stipend for being on call, but any newborn care is included into the monthly RVU total. That includes circumcisions and standard newborn hospital care (H&P, DC, etc.). On occasion I will assist with a crash Cesarean and get surgical assistant for that (16 RVU's yeah!) as well as neonatal resuscitation.
NURSING HOME
I go to a nursing home for a few hours once per week. The typical nursing home visit codes are there. We are getting long term patients enrolled into our Chronic Care Management program so we can capture some there (we have an actually rather comprehensive CCM program here with a lot of ancillary staff). I don't really do any special procedures or anything there otherwise.
OUTPATIENT
All the standard office visit types are there per usual (New/Established, Consults, TCM, Preventive visits, Medicare AWV, School/Sports Physicals, etc.). Examples of non-office visit related RVUs generated on my list include:
- Standard Family Med Procedures: abscesses, biopsies, OMT, joint injections/aspirations, earwax removal, and other odd ball procedures etc.
- Electrocardiogram interpretation
- Immunization administration
- Smoking cessation counseling
- Goals of care counseling ("Advanced care planning")
- CPAP ventilation, initiation & management
- Rarely prolonged service codes
- Pap smear collection
INPATIENT
I also do hospitalist shifts and get paid hourly for that (2hr base pay regardless plus $/hr for any additional hours that are reported). Sometimes Hospital Care Initial/Discharge and Observation Care shows up on my monthly reports, but it seems very inconsistent with reality and makes me question where they are pulling the data. On the other hand I do get paid hourly so I feel like any RVUs showing up is like double dipping to me (paid hourly + paid for RVU generation)... I almost hesitate to even bring this up for that reason.
L&D
I also see newborns in the hospital and do circumcisions. We get paid a weekly stipend for being on call, but any newborn care is included into the monthly RVU total. That includes circumcisions and standard newborn hospital care (H&P, DC, etc.). On occasion I will assist with a crash Cesarean and get surgical assistant for that (16 RVU's yeah!) as well as neonatal resuscitation.
NURSING HOME
I go to a nursing home for a few hours once per week. The typical nursing home visit codes are there. We are getting long term patients enrolled into our Chronic Care Management program so we can capture some there (we have an actually rather comprehensive CCM program here with a lot of ancillary staff). I don't really do any special procedures or anything there otherwise.