Reimbursement for Common PM&R Procedures

[drusso]

From time to time, people post asking how much physiatrists make for common procedures. Here's a run-down based upon the lastest RUV's (which is a system used to calculate physician work) and the latest medicare reimbursement conversion factor passed by congress (which is a $36.79 multiplier). Thus, the total reimbursement (for medicare at least) is determined by multiplying the RUV times the conversion factor.

This info is also available at www.aapmr.org

Code and Services 2003 Total RVUs Conversion
Injection(s); tendon sheath, ligament 1.57 $57.76
Injection(s); tendon origin/insertion 1.51 $55.55
Injection(s); single or multiple trigger point(s), one or two muscle(s) 1.38 $50.77
Injection(s); single or multiple trigger point(s), three or more muscle(s) 1.56 $57.39
Arthrocentesis, small joint 1.38 $50.77
Arthrocentesis, intermediate joint 1.52 $55.92
Arthrocentesis, major joint 1.84 $67.69
Injection, sciatic nerve 4.34 $159.67
Injection, peripheral nerve or branch 2.65 $97.49
Injection, paravertebral facet joint or facet joint nerve; cervical or thoracic, single level 6.96 $256.06
Injection, paravertebral facet joint or facet joint nerve; lumbar or sacral, single level 6.15 $226.26
Injection, transforaminal epidural; cervical or thoracic, single level 9.66 $355.39
Injection transforaminal epidural; lumbar or sacral, single level 9.77 $359.44
Destruction, paravertebral facet joint nerve, single level
11.7 $430.44
EMG 1 limb global 2.63 $96.76
EMG 2 limbs global 3.08 $113.31
EMG 3 limbs global 3.75 $137.96
EMG 4 limbs global 4.81 $176.96
Motor nerve conduction global 1.57 $57.76
Nerve conduction, F-wave, global 1.71 $62.91
Sensory nerve conduction, global 1.32 $48.56
Short latency, somatosensory, lower limb, global 1.76 $64.75
Short latency, somatosensory, trunk or head, global 1.79 $65.85
H-reflex, amplitude & latency study global 0.99 $36.42
Mechanical traction therapy 0.33 $12.14
Ultrasound therapy 0.3 $11.03
Gait training therapy 0.67 $24.65
Group therapy 0.5 $18.40
Office visit new, level 1 0.95 $34.95
Office visit new, level 3 2.52 $92.71
Office visit established, level 1 0.56 $20.60
Office visit established, level 3 1.39 $51.14
Office visit established, level 4 2.17 $79.83
Hospital visit, initial level 1 1.79 $65.85
Hospital visit initial, level 3 4.13 $151.94
Hospital visit subsequent, level 1 0.89 $32.74
Hospital visit subsequent, level 3 2.09 $76.89
Office consult, level 1 1.29 $47.46
Office consult, level 3 3.17 $116.62
Office consult, level 4 4.51 $165.92
Hospital consult, level 1 0.95 $34.95
Hospital consult, level 3 2.61 $96.02
Hospital consult, level 4 3.75 $137.96

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[gecko]

Thanks Drusso...that was very helpful!

Are these procedures learned mainly in a pain fellowship (all the nerve and facet joint injections) or musculoskeletal fellowship?

Gecko

 

[bigfrank]

I'm also interested in gecko's question

Also, any knowledgeable comments in addition to drusso's objective facts about the new reimbursement schedules.