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How You Can Take A More Active Role In CMS Reimbursement

Patrick DeHeer DPM FACFAS

When opportunities are available for you to provide input as to how the Centers for Medicare and Medicaid Services (CMS) pay you, active participation in the process is critical.

The CMS utilizes the Relative Value Scale Update Committee (RUC) surveys to review physician work for certain Current Procedural Terminology (CPT). These surveys are an opportunity for you provide direct input on Medicare payments. Components of physician work, practice expense and professional liability insurance determine procedure payments. The surveys seek your input on the time, complexity and work for the CPT code being reviewed in comparison to an existing reference procedure. The committee uses this data to estimate the recommended professional work value.

Members of medical societies/associations periodically receive surveys to ensure the value placed on CPT codes is accurate and fair. The American Podiatric Medical Association (APMA) sends out surveys to its members. Each survey has a deadline for completion. This deadline is important because it allows analysis of the data before the APMA presents it to the Relative Value Scale Update Committee. The committee reviews recommendations from specialty societies and associations at committee meetings three times a year. The Relative Value Scale Update Committee subsequently submits this data to CMS. The CMS publishes these recommendations in July and the values go into effect the following January.

The APMA has put together an informative webinar on the survey process on its website (https://www.apma.org/workingforyou/EventDetail.cfm?EventID=61482 ).

These surveys take approximately 15 to 20 minutes to complete. Your participation is critical. Please review the webinar information and fill out these surveys. Do not allow this opportunity to slip by when you can actively participate in the development of accurate reimbursement for your services.

 

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