The work RVUs represent about 51% of a CPT code’s value, which is based on time and intensity. The RUC process includes comparing survey data to recently valued codes within and outside of the affected specialty to provide “relativity.”
Dr. Edelstein urged physicians to respond to RUC surveys, which provide the information the committee needs for its deliberations. In doing so, clinicians should be specific and remember that valuation is based on a “typical” case, not the easiest or most difficult.
The practice expense RVUs are based on clinical staff time, equipment costs, time used, and supplies. When the committee meets to discuss peRVUs, debates can come down to such minutiae as arguments over how many cotton swabs are needed for an exam. In this component of the valuation process, eye care practitioners have somewhat of an advantage, Dr. Edelstein said.
“Ophthalmology fares well because of the greater cost of office equipment (ophthalmology lane) needed for an eye exam compared to what an internist would need for a physical (exam table),” he said.
The third leg of the valuation formula, professional liability expense, constitutes a surprisingly small component of the calculation. pliRVUs account for about 4.3% of the total value, compared to 51% for work value and about 45% for practice expenses.