Originally Posted by drrinoo
The practice expense is only one component of the RVU...the other components being the work component and the malpractice component..ordinarily the practice expence is about ?20-40% of the total RVU based on the procedure....
The proposed reduction will be in the practice expense.
Anyone know whether CMS is primarily using overhead expense data for 2007 from anesthesiologists (low overhead-hospital based) or from interventional pain physicians/physiatrists (higher overhead).
That's the problem. Despite aggressive campaigning by ASIPP pain docs are not using the 09 specialty code. I think you need to reach a certain threshold in terms of numbers for CMS to do a separate practice cost analysis and we haven't reached it. The danger, then, is that they will use the anesthesiology practice cost for the calculation, which is far less than an office-based pain specialist.
As for the quote above about office and ASC fees, what they are saying is that if you do a procedure in the ASC that could be done in the office, the reimbursement is capped at office rates. They are trying to drive procedures into the office. They did this with oncology: they gave them financial incentives to do chemo in the office. After everyone went out on that limb they sawed it off and cut chemo reimbursement in the office.
The pain docs get off their butts and register under the 09 code, and Congress has to wake up to the fact that they are looking at 80 million Medicare beneficiaries entering the system as the boomers age. It simply isn't realistic to expect to keep expenses down when volume increases like that.