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THE AMERICAN MEDICAL ASSOCIATION (AMA)/SPECIALTY SOCIETY RELATIVE VALUE SCALE (RVS) UPDATE COMMITTEE (RUC) WAS FORMED IN 1991 to make recommendations to the Centers for Medicare and Medicaid Services (CMS) on the relative values-assigned to new or revised codes in the Current Procedural Terminology (CPT) book. The RUC reviews medical services in comparison with other medical services with similar physician work. The CMS considers the RUC recommendations and assigns reimbursement amounts for medical services in the upcoming calendar year Medicare Physician Fee Schedule.
The RUC is an expert panel comprised of 29 members, the majority of whom are physicians. Panel members are expected to exercise independent judgment and are not advocates for their medical specialty. The RUC meets 3 times a year to review and make recommendations on the values assigned to CPT codes used to designate specific medical services. Also, as part of its ongoing work, the RUC conducts a rolling 5-year review to examine CPT codes that are perceived to be misvalued.
The RUC is supported by an advisory committee of over 100 specialty societies and healthcare professional organizations that collect data and formally present recommendations to the RUC regarding suggested values for specific CPT codes. An integral part of this process is the collection of specialty society survey data to support suggested values for specific medical services. The RUC in turn examines the specialty society survey data and work value recommendations as part of its process to develop relative value units for physician work, physician time, and practice expense recommendations to CMS.
We, as physicians, have an important opportunity to participate in this process. You may receive a survey asking you to complete questions that will help to determine reimbursement values for cardiovascular services. It is absolutely crucial that you bring this survey to the attention of your staff and that you, the physician, fill it out accurate and completely. The RUC survey is used to obtain estimates of the time and complexity required to perform a procedure and a recommended professional work value. The survey asks you to compare the time, complexity, and work needed to perform the surveyed procedure compared to a procedure already valued by the RUC. Your survey responses will form the basis of evidence submitted to the RUC. It is important to note that the CMS has recognized the expertise of the RUC by adopting 90% of the RUC's work relative value recommendations since its inception.
This is a data-driven process, and without appropriate data, we cannot expect to receive accurate reimbursement for the services we provide. A pool of inaccurate surveys will skew the results and will have a potential negative impact on RUC recommendations for work values.
If you do receive a survey, please take the time to complete it. All of us have a responsibility to take this process seriously and to participate when offered the opportunity to do so.
- American College of Cardiology Foundation