Essential RBRVS Updateable Data File
Optum
The Essential RBRVS gives you all the codes valued by CMS, as well as relative values for many codes not valued for Medicare. The RBRVS for the Medicare physician fee schedule (MPFS) is used to set physician fees by Medicare and many commercial payers. However, the RBRVS does not provide a complete schedule. Medicare does not assign relative value units (RVUs) for many services. Codes not valued for Medicare are referred to as “gap” codes. The Essential RBRVS provides Medicare values and “gap” values to enable you to develop a more complete fee schedule.
- Includes the same data relied on by over 70 percent of commercial payers. Negotiate stronger managed care contracts.
- Medicare payment indicators included. Global days, multiple procedure reduction, assistant surgery, pre-op, intra-op and post-op percentages and other indicators commonly used for Medicare and commercial claims.
- Gap values for complete fee schedule development. Relative values for many codes not valued by CMS for the Medicare Physician Fee Schedule.
- Organized by CPT® and HCPCS codes. Consistently value services and procedures from different code sets.
- Total values and components for each code—including work, malpractice, practice expense, and total RVUs. Evaluate and analyze the costs associated with a service, providing a more complete picture of your reimbursement.
Multi-user licensing available.
Nannette Orme, CCS-P
Ms. Orme has more than 30 years of experience in the healthcare profession. She has extensive background in CPT/HCPCS and ICD-9-CM coding and has completed comprehensive ICD-10-CM and PCS training. Her prior experience includes physician clinics and healthcare consulting. Her areas of expertise include physician audits and education, compliance and HIPAA legislation, litigation support for Medicare self-disclosure cases, hospital chargemaster maintenance, workers' compensation, and emergency department coding. Ms. Orme has presented at national professional conferences, contributed articles for several professional publications, and served on the advisory board of a local college. She is a member of the American Academy of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA).
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