2023 wRVU Changes

[psych_0]

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Any wRVU savy folks see the new changes for wRVUs in 2023? I only work inpatient, but these seem pretty big. Nice bumps to 99231-3 and 99239. Also, I've never used code 99236 but does anyone know if that would work on these common malingering homeless admissions who get admitted by the ED overnight and then discharged in the morning? It's not much, but 4.2 is more than the 4.16 you'd get for a 90792.

 

[yanks26dmb]

Any wRVU savy folks see the new changes for wRVUs in 2023? I only work inpatient, but these seem pretty big. Nice bumps to 99231-3 and 99239. Also, I've never used code 99236 but does anyone know if that would work on these common malingering homeless admissions who get admitted by the ED overnight and then discharged in the morning? It's not much, but 4.2 is more than the 4.16 you'd get for a 90792.

But overall were still making less in 2023 because the conversion factor went down, no? Also didnt see anything for outpatient codes - any word on that?

 

[psych_0]

But overall were still making less in 2023 because the conversion factor went down, no? Also didnt see anything for outpatient codes - any word on that?

I don't understand what you mean by that? My contract wRVU multiplier is the same and has not changed. After I hit my wRVU target, which will now be much sooner than before, I'll be getting paid $X / wRVU for a bonus until the contract year restarts. I usually see 12-13 patients per day + 1 weekend a month seeing 20-25 pts each of those days. Last year I hit >8200 wRVU. Impossible I go under than number this year with those changes.

 

[yanks26dmb]

I don't understand what you mean by that? My contract wRVU multiplier is the same and has not changed. After I hit my wRVU target, which will now be much sooner than before, I'll be getting paid $X / wRVU for a bonus until the contract year restarts. I usually see 12-13 patients per day + 1 weekend a month seeing 20-25 pts each of those days. Last year I hit >8200 wRVU. Impossible I go under than number this year with those changes.

Could be that I'm misinterpretting the information, but I saw the conversion factor per medicare is dropping from ~34.6 to ~33 in 2023.

 

[psych_0]

Could be that I'm misinterpretting the information, but I saw the conversion factor per medicare is dropping from ~34.6 to ~33 in 2023.

Yea that doesn't apply to my salary at all, at least not under my current contract structure. Maybe during contract renegotiations this may come up, but it didn't come up the first time and I don't see why it would come up next time.

 

[Stagg737]

But overall were still making less in 2023 because the conversion factor went down, no? Also didnt see anything for outpatient codes - any word on that?

CMS will reimburse less per RVU because of the decreased conversion factors, however this may or may not be reflected in how employers reimburse for earned wRVUs. Overall probably will not make a huge difference. Also, if you do the math the bump in reimbursement makes up for the drop for the inpt f/up codes:

	2022 wRVUs	2022 $ ($34.6/RVU)	2023 wRVUs	2023 $ ($33/RVU)
99231	.76	26.30	1.0	33 (+ $6.70)
99232	1.39	48.09	1.59	52.47 (+ $4.38)
99233	2.0	69.2	2.4	79.2 (+ $10)

So doing the math you should be making more for most codes as most for psych increased. Now if we're also trying to account for inflation...

 

[yanks26dmb]

CMS will reimburse less per RVU because of the decreased conversion factors, however this may or may not be reflected in how employers reimburse for earned wRVUs. Overall probably will not make a huge difference. Also, if you do the math the bump in reimbursement makes up for the drop for the inpt f/up codes:

	2022 wRVUs	2022 $ ($34.6/RVU)	2023 wRVUs	2023 $ ($33/RVU)
99231	.76	26.30	1.0	33 (+ $6.70)
99232	1.39	48.09	1.59	52.47 (+ $4.38)
99233	2.0	69.2	2.4	79.2 (+ $10)

So doing the math you should be making more for most codes as most for psych increased. Now if we're also trying to account for inflation...

Yeah I didnt actually run the numbers.. that makes sense though. So essentially we should be generating more money for our work/the hospitals should be paying us more.

 

[Wheatbread]

This looks good. Hopefully my system doesn’t lower our $/WRVU to compensate. They haven’t told us about these changes yet. They also finally updated the outpatient codes that changed last year for us on the outpatient side. I’m cautiously hopeful.

 

[nexus73]

did coding rules change for inpatient e/m?