References
- This research was supported by the Health Care Financing Administration.
- Levy, J. M., Borowitz, M., et al. Understanding the Medicare Fee Schedule and Its Impact on Physicians Under the Final Rule. Med Care, 1992 (in press.)
- HCFA and the AMA did not accept Harvard's recommendation on the role of time in these codes. Time, in the new codes, is secondary to the content of the service provided.
- At She time of the legislation, HCFA did not recognize hematology or oncology as a separate specialty. In this article, because we lack Medicare data on hematology/oncology, we use the result for general internal medicine for the purpose of comparison.
- Hsiao, W.C., Braun, P., et al. A National Study of Resource-Based Relative Value Scales for Physician Services: Phase 1 Final Report to the Health Care Financing Administration. (Boston: Harvard School of Public Health, 1988). HCFA Contract No. 17-C-98795/1-03.
- Hsiao, W.C., Braun, P., et al. A National Study of Resource-Based Relative Value Scales for Physician Services: Phase II Final Report to the Health Care Financing Administration. (Boston: Harvard School of Public Health, 1990). HCFA Contract No. 17-C-98795/1-03.
- Hsiao, W.C., Braun, P., et al. A National Study of Resource-Based Relative Value Scales for Physician Services: Phase III Final Report to the Health Care Financing Administration. (Boston: Harvard School of Public Health, 1992). HCFA Contract No. 17-C-98795/1-03. (In press.)
- The reference service was selected to represent a commonly performed service about which all members of the specialty would be knowledgeable. The method of magnitude estimation permitted respondents to rate other services as high or as low, relative to the standard, that they felt was appropriate.
- Evans, M.M. “RBRVS: A Drastic Change in Physician Reimbursement,” Onc. Issues 7:1 (Winter 1992): 15–16, and Miller, C.S., “The Impact of the Final RBRVS Rules on Oncology Practices,” 17-19.
- Hsiao, W.C., Braun, P., et al. A National Study of Resource-Based Relative Value Scales for Physician Services: Phase I Final Report to the Health Care Financing Administration. (Boston: Harvard School of Public Health, 1988). HCFA Contract No. 17-C-98795/1-03.
- For example, the practice cost component of a typical office visit (CPT 99213) is $13. while practice costs for a 3-vessel CABG (CPT 33512) are $1,197—a ratio of 92 to 1. The ratio of the work component of the fee schedule is 45 to 1 or half of the practice cost ratio. A physician would have to provide 92, 15-minute office visits—a total of 23 hours of patient care—to earn practice cost revenues equal to a single 8-5 hour surgical services (including pre- and post-service visits).
- Latimer, E.L., and Becker E.R. Incorporating Practice Costs Into the RBRVS. Med Care 1992 (In press).
- Physician Payment Reform Commission. Practice Expenses Under the Medicare Fee Schedule: A Resource-Based Approach. (Washington DC: Physician Payment Review Commission. 1992). Pub. No. 92-1.