Application of the resource-based relative value scale system to pediatrics

Samuel D. Smith, Robert S. Gerstle, Margie C. Andreae, Joel F. Bradley, Steven E. Krug, Jeffrey F. Linzer, Richard A. Molteni, Julia M. Pillsbury, Allen D. Schwartz, Richard H. Tuck, Lynn M. Wegner, Becky Dolan, Teri Salus, Linda Walsh

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

With an increased focus on payment and productivity measurement in health care, it is essential to understand the genesis and principles behind the Medicare Resource-Based Relative Value Scale (RBRVS) physician fee schedule. The majority of third-party payers, including a growing number of Medicaid programs and commercial payers, use variations of the Medicare RBRVS as their basis for physician payment. Many group practices have also adopted this system to benchmark physician productivity and determine variable compensation and bonus payments. Because pediatric care is underrepresented in any Medicare-based payment system analysis, unique aspects of physician work and practice expense may not be accurately reflected in the total relative value units (RVUs) for certain pediatric services. Despite this potential limitation, the American Academy of Pediatrics supports the use of Current Procedural Terminology (CPT) codes to report unique physician work and the RBRVS physician fee schedule as a uniform payment system. The American Academy of Pediatrics will continue to work to rectify perceived inequities of the RBRVS system as they pertain to pediatrics.

Original languageEnglish (US)
Pages (from-to)1395-1400
Number of pages6
JournalPediatrics
Volume122
Issue number6
DOIs
StatePublished - Dec 1 2008

Keywords

  • Based
  • Coding
  • Payment
  • Pediatrics
  • Physician work
  • Practice expense
  • RBRVS
  • Relative
  • Resource-
  • Resource-based relative value scale
  • Scale
  • System to
  • Value

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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  • Cite this

    Smith, S. D., Gerstle, R. S., Andreae, M. C., Bradley, J. F., Krug, S. E., Linzer, J. F., Molteni, R. A., Pillsbury, J. M., Schwartz, A. D., Tuck, R. H., Wegner, L. M., Dolan, B., Salus, T., & Walsh, L. (2008). Application of the resource-based relative value scale system to pediatrics. Pediatrics, 122(6), 1395-1400. https://doi.org/10.1542/peds.2008-2578