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The RBRVS for each CPT code is determined using three separate factors: physician work, practice expense, and malpractice expense. The average relative weights of these are: physician work (52%), practice expense (44%), malpractice expense (4%). [2] A method to determine the physician work value was the primary contribution made by the Hsiao study.
Before RVUs were used, Medicare paid for physician services using "usual, customary and reasonable" rate-setting which led to payment variability. [2] The Omnibus Budget Reconciliation Act of 1989 enacted a Medicare fee schedule, and as of 2010 about 7,000 distinct physician services were listed. [2]
In the United States, an independent practice association (IPA) is an association of independent physicians, or other organizations that contracts with independent care delivery organizations, and provides services to managed care organizations on a negotiated per capita rate, flat retainer fee, or negotiated fee-for-service basis. [1] [2]
Medical Economics Inc. merged with Reinhold Publishing in 1966 to form Chapman-Reinhold. [3] Litton Industries , which owned the American Book Company , acquired Chapman-Reinhold in 1968. [ 4 ] Litton sold its publishing business to the International Thomson Organization (ITO) in 1981.
As of June 2024, the file download size is 947.84 MB, and the raw database file (npidata_pfile_20050523-20240512.csv) is 9.3 GB when extracted. [7] The size of the data has been steadily growing over time. The size of the raw database file was 8.8GB in June 2023, and 8.2GB in June 2022.
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The AMA also charges data mining companies such as IQVIA a fee for access to the Physician Masterfile, which they then use to identify physicians within prescription data purchased from pharmacies. [3] This enriched, prescriber-identified prescription data is then sold to pharmaceutical companies that use it to monitor marketing effectiveness.