FROM MY PT SCHOOL NOTES · HEALTHCARE SYSTEMS · UNIT 1 · CHAPTER 05
Physician fee schedule and RVUs
05 Physician fee schedule and RVUs Why can the same CPT code have different payment amounts?
Core ideas from class
- The course introduces the resource-based relative value scale (RBRVS), relative value units (RVUs), geographic adjustment and the fee schedule payment framework.
- Think of a fee schedule as a rule for calculating payment; do not mistake a published charge or billed price for the final allowed amount.
- Multiple-procedure payment reduction (MPPR) and modifiers may affect claims; the exact current mechanism belongs in the active payer policy.
Think like a PT
Two clinics bill the same therapeutic service. Compare place of service, contract, geography and adjustments before claiming that one clinic is “overbilling.”
Remember
Payment is not simply number of visits multiplied by the clinic’s sticker price.
Historical source note: Any numerical fee example or conversion factor in the lecture is illustrative only.
From my class sources: 7 Medicare Fee Schedule.pdf. These are personal school notes with additional editorial context, not current legal advice, payer guidance, a coding manual, or a guaranteed reimbursement rule. Verify any current policy directly.
