1. What is the Medicare Conversion Factor?

The Medicare Conversion Factor (CF) is a dollar amount that converts the Relative Value Unit (RVU) into a payment amount. It's updated annually by CMS and is used to calculate physician payments under the Medicare Physician Fee Schedule.

2. How Does the Calculator Work?

The calculator uses the Medicare payment formula:

Where:

• \( CF \) — Conversion Factor in dollars per RVU
• \( RVU \) — Relative Value Unit (unitless)

Explanation: The equation multiplies the current Medicare conversion factor by the total RVUs for a service to determine the payment amount.

3. Importance of Payment Calculation

Details: Accurate payment calculation is crucial for healthcare providers to understand reimbursement rates, practice budgeting, and financial planning under Medicare.

4. Using the Calculator

Tips: Enter the current Medicare conversion factor in $/RVU and the total RVUs for the service. Both values must be positive numbers.

5. Frequently Asked Questions (FAQ)

Q1: Where can I find the current Medicare CF?
A: The annual CF is published by CMS in the Federal Register, typically in November for the following year.

Q2: How often does the CF change?
A: The CF is updated annually, though mid-year changes can occur due to legislative actions.

Q3: What components make up RVUs?
A: RVUs typically include three components: physician work, practice expense, and malpractice expense.

Q4: Does this calculator account for geographic adjustments?
A: No, this calculates the base payment. Geographic Practice Cost Indices (GPCIs) would need to be applied separately.

Q5: Can this be used for non-Medicare payers?
A: Some private payers use Medicare's methodology but with different conversion factors. Check with individual payers for their specific rates.