1. What is the RBRVS Conversion Factor?

The RBRVS (Resource-Based Relative Value Scale) Conversion Factor is used by Medicare to determine physician payments. It converts the total RVUs (Relative Value Units) of a service into a dollar payment amount.

2. How Does the Calculator Work?

The calculator uses the RBRVS payment formula:

Where:

• \( CF_{Medicare} \) — Medicare conversion factor in dollars per RVU
• \( Total\ RVU \) — Sum of work RVU, practice expense RVU, and malpractice RVU

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

3. Importance of RBRVS Calculation

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

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: What is the current Medicare conversion factor?
A: The CF changes annually. Check the CMS website for the current year's value (typically around $32-$35 per RVU).

Q2: How are total RVUs determined?
A: Total RVU = Work RVU + Practice Expense RVU + Malpractice RVU, as defined by CMS for each CPT code.

Q3: Does this calculator work for non-Medicare payers?
A: No, this calculates Medicare payments only. Private insurers may use different conversion factors.

Q4: Where can I find RVU values?
A: CMS publishes RVU values in the Medicare Physician Fee Schedule (MPFS).

Q5: Are geographic adjustments included?
A: No, this calculates the base payment. Geographic Practice Cost Indices (GPCIs) would adjust this further.