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  2. Resource-based relative value scale - Wikipedia

    en.wikipedia.org/wiki/Resource-based_relative...

    In December of the following year, President George H. W. Bush signed into law the Omnibus Budget Reconciliation Act of 1989, switching Medicare to an RBRVS payment schedule. This took effect on January 1, 1992. Starting in 1991, the AMA has updated RBRVS continually. As of May 2003, over 3500 corrections have been submitted to CMS.

  3. Relative value unit - Wikipedia

    en.wikipedia.org/wiki/Relative_value_unit

    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]

  4. Specialty Society Relative Value Scale Update Committee

    en.wikipedia.org/wiki/Specialty_Society_Relative...

    Before the 1992 implementation of the Medicare fee schedule, physician payments were made under the "usual, customary and reasonable" payment model (a "charge-based" payment system). Physician services were largely considered to be misvalued under this system, with evaluation and management services being undervalued and procedures overvalued ...

  5. Medical necessity - Wikipedia

    en.wikipedia.org/wiki/Medical_necessity

    Medicare Coverage Database which includes NCDs, LMRP/LCDs, as well as NCAs & CALs, from cms.hhs.gov Physician Fee Schedule lookup at cms.hhs.gov Defining Medical Necessity Under the Patient Protection and Affordable Care Act at academia.edu, by Daniel R. Skinner, published in the journal Public Administration Review (2013).

  6. Geographic pricing cost index - Wikipedia

    en.wikipedia.org/wiki/Geographic_pricing_cost_index

    Geographic Practice Cost Index is used along with Relative Value Units by Medicare to determine allowable payment amounts for medical procedures. There are multiple GPCIs: Cost of Living, Malpractice, and Practice Cost/Expense. These categories allow Medicare to adjust reimbursement rates to take into account regional and practice-specific ...

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  8. Medicare (United States) - Wikipedia

    en.wikipedia.org/wiki/Medicare_(United_States)

    On January 1, 1992, Medicare introduced the Medicare Fee Schedule (MFS), a list of about 7,000 services that can be billed for. Each service is priced within the Resource-Based Relative Value Scale (RBRVS) with three Relative Value Units (RVUs) values largely determining the price. The three RVUs for a procedure are each geographically weighted ...

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