1. What is the Medicare Conversion Fee?

The Medicare Conversion Fee is calculated by multiplying the Conversion Factor (CF) by Relative Value Units (RVU). This determines the payment amount for medical services under Medicare's physician fee schedule.

2. How Does the Calculator Work?

The calculator uses the Medicare fee formula:

Where:

• \( CF \) — Conversion Factor (dollars per RVU)
• \( RVU \) — Relative Value Units (unitless measure of service complexity)

Explanation: The equation accounts for both the standardized conversion rate and the relative value assigned to each medical service.

3. Importance of Medicare Fee Calculation

Details: Accurate fee calculation is crucial for healthcare providers to understand Medicare reimbursement rates and for financial planning in medical practices.

4. Using the Calculator

Tips: Enter the current Conversion Factor in dollars per RVU and the RVU value for the specific service. Both values must be positive numbers.

5. Frequently Asked Questions (FAQ)

Q1: What is the current Medicare Conversion Factor?
A: The CF is updated annually. As of 2023, it's approximately $33.89/RVU, but always verify the current year's rate.

Q2: How are RVUs determined?
A: RVUs are assigned by CMS based on physician work, practice expense, and malpractice expense components for each CPT code.

Q3: Does this calculator work for all Medicare services?
A: Yes, but you need the specific RVU for each service. Different procedures have different RVU values.

Q4: Are there geographic adjustments?
A: Yes, Medicare applies geographic practice cost indices (GPCIs) that adjust the final fee based on location.

Q5: Can this be used for non-Medicare payers?
A: Some private insurers use similar formulas but may have different conversion factors or RVU valuations.