Calculate Medicare Payment Schedule on RBRVS - Definition, Formula, Example

Learn How to Calculate Resource Based Relative Value

Definition:

Resource-based relative value scale (RBRVS) is nothing but a representation which is used to calculate the amount medical providers should be paid.This tutorial explains you how to calculate the payment using Resource-based relative value scale.

Formula:
Payment = [(RVU work x GPCI work) + (RVU expense x GPCI expense) + (RVU malpractice insurance cost x GPCI malpractice insurance cost)] x conversion factor Where, RVU = Relative Value Units GPCI = Geographic Pricing Cost Index
Example :

In a midlevel office visit for an established patient, the RVU for the physical work is 1500 and the GPCI factor for that physical work is 2 and the RVU for practice expense is 2700 and the GPCI factor is 4 Similarly the RVU for malpractice insurance cost is 2800 and the GPCI is 3. Calculate the total payment when the conversion factor is 20.

Given,

RVU work = 1500 GPCI work = 2 RVU expense = 2700 GPCI expense = 4 RVU malpractice insurance cost = 2800 GPCI malpractice insurance cost = 3 Conversion factor = 20

To Find,

Medicare Payment Schedule on RBRVS (Total Payment)

Solution:
Total payment [(RVU work x GPCI work) + (RVU expense x GPCI expense) + (RVU malpractice insurance cost x GPCI malpractice insurance cost)] x conversion factor
[(1500 x 2) + (2700 x 4) + (2800 x 3)] x 20
(3000 + 10800 + 8400) x 20
22200 x 20
444000

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