Specialty Exceptions — 2018 PE RVU Changes

by  Raquel Shumway
Dec 13th, 2017

A little history on where the data for the RVUs comes from might help our understanding of the recent RVU revisions released in the 2018 Physician Fee Schedule Final Rule.

In 2007 there was a new survey done by the AMA; The Physician Practice Expense Information Survey (PPIS). In CY 2010 the data base used to determine the PE RVU was updated with the information from this 2007 survey.

The 4 year transition to the PPIS data was completed in CY 2013 and since then PE RVUs have been based entirely on PPIS data. However, there are a few specialties that this does not apply to.

Supplemental survey data is used for the following specialties rather than the PPIS data for a couple of reasons. Some specialties did not participate in the PPIS and some are not separately recognized by Medicare. The data used for these specialties is taken from supplemental survey data collected from other sources or from crosswalks created by CMS.

• Oncology
• Hematology
• Hematology/Oncology
• Pathologists — for payments beginning CY2005
• Radiology – for payments beginning CY2007
• Reproductive endocrinology
• Spine surgery

Note: Crosswalks are established through the rulemaking process. See “CY 2018 PFS Final Rule PE/HR”