2019 HSC Section 2 - Practice Management

J A M A CAD D ERMATOL A PRIL 2018

Barbieri et al

Fig 1. Summary of the American Medical Association and Specialty Society RUC process. CMS , Centers for Medicare and Medicare Services; RUC , Relative Value Scale Update Committee.

RUC subcommittees In addition to the primary RUC review committee, there are several important RUC subcommittees. To ensure the accuracy of the practice expense component of the RBRVS, the RUC established the Practice Expense Subcommittee. This subcommittee reviews the direct (eg, supplies, equipment) and indirect (eg, clinical staff) expense inputs used by CMS to calculate the practice expense RVUs and assists the RUC with making methodologic and code-specific recommendations to CMS. The Relativity Assessment Workgroup (RAW) works to identify codes in need of review by the RUC. There are a variety of criteria used by the RAW,

including substantial increases in volume, changes in the specialty that most often performs the service, and changes in the location where the service is typically performed (ie, inpatient hospital vs outpatient clinic). Codes that are frequently reported together are also often identified by the RAW because it is thought that if 2 procedures are typically performed on the same day for the same patient, then reimbursing them as a single procedure (ie, bundling) might be more efficient. To allow for participation of nonphysician providers in the RUC process, the Health Care Professionals Advisory Committee was formed. Members are nominated by their respective specialty

44