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Essential RBRVS Updateable Data File


Essential RBRVS Updateable Data File
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Publisher: Optum
Experts: Lauri Gray, RHIT, CPC
Sample Pages:  View PDF

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2018 Data File
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2019 Data File
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The Essential RBRVS gives you all the codes valued by CMS, as well as relative values for many codes not valued for Medicare. The RBRVS for the Medicare physician fee schedule (MPFS) is used to set physician fees by Medicare and many commercial payers. However, the RBRVS does not provide a complete schedule. Medicare does not assign relative value units (RVUs) for many services. Codes not valued for Medicare are referred to as “gap” codes. The Essential RBRVS provides Medicare values and “gap” values to enable you to develop a more complete fee schedule. Read more

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Features and benefits


  • Includes the same data relied on by over 70 percent of commercial payers. Negotiate stronger managed care contracts.
  • Medicare payment indicators included. Global days, multiple procedure reduction, assistant surgery, pre-op, intra-op and post-op percentages and other indicators commonly used for Medicare and commercial claims.
  • Gap values for complete fee schedule development. Relative values for many codes not valued by CMS for the Medicare Physician Fee Schedule.
  • Organized by CPT® and HCPCS codes. Consistently value services and procedures from different code sets.
  • Total values and components for each code—including work, malpractice, practice expense, and total RVUs. Evaluate and analyze the costs associated with a service, providing a more complete picture of your reimbursement.

    CPT® is a registered trademark of the American Medical Association.

    *Single user pricing only. Please call for multi-user licensing.



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Content Experts


Lauri  Gray, RHIT, CPC - Ms. Gray has over 20 years of experience in health information management. She began her career as a medical records supervisor in a multispecialty clinic and then shifted to the managed care industry, where she was employed as a contracting and coding specialist for a major HMO. Ms. Gray has extensive experience in fee schedule development and analysis, which includes an in-depth knowledge of risk contracting and the development of capitation rates. Ms. Gray has been a technical editor for Ingenix since 1998.


 
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