May 11, 2023

Medicare Physician Fee Schedule Final Rule

ARTICLE TOPICS

 

With the 2022 Medicare Physician Fee Schedule Final Rule approved to go into effect in 2024, split/shared billing is on the minds of many.

Complexities like shared billing have been present for decades. In addition, we’ve seen that wRVUs generated by many EHRs are not matching up to what orgs are paying docs to begin with because of complex adjustments processes around methodologies like multiple and bilateral procedures that are not being considered by those systems.

This waters down the collective pool, creates inequities across your provider base, and makes aligning with benchmarking futile.

For example, we’ve seen orgs overpay certain specialties by 20-50% ($100K-$200k+/yr/provider in some cases) above what is collected in reimbursements. While this creates an immediate budgeting issue, the true cost to the organization is how those inequities flow to specialties like Primary Care and Hospitalist which do not have use cases that are inflating their wRVU value. 

We’re actively working on closing this gap for our clients, with exciting advancements to come soon.

Stay tuned for information on how you can test your systems methodology!

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