Free RBRVS Calculator For Your Medical Practice

My friends over at Pedsource just published a free RBRVS Calculator based on 2012 data. According to the post, the data is using an annual conversion factor of $24.60. They caution that this number will change sometime between today (12/8/11) and March, 2012.

Because the AMA doesn’t let anyone provide a free RVU calculator that includes CPT codes due to their CPT copyrights (booo, booo), the great folks at Pedsource (yaaay, yaaay) created this tool for those of us who have a CPT license that allows for a use such as this. In theory, that should mean any practice that submits insurance claims.

What is this tool good for?

The tool allows you to choose your CMS-driven location, set a Medicare Multiplier, and then, on a code-by-code basis, determine your pricing level. Basically, you can use this spreadsheet with the data that you can download from CMS to make a fairly sophisticated RVU calculator in about 5 minutes.

One can then include your practice’s own common codes, volume and pricing, and the spreadsheet will determine your practice’s FACF (i.e., how much you charge, on average, relative to Medicare).

You can also put in your practice’s payment information and the sheet will compare it to the Medicare fee schedule.

(By the way, I recently used this exact tool before I sat down with UHC last week to get an idea of how UHC was paying based on the Medicare fee schedule. The sheet provided me with a lot of insight that proved valuable during my meeting with them)
 

How does it work?

  1. Download the OpenOffice version or the MS Excel version of the RVU calculator.
  2. Visit the CMS site and download the 2012 RVU zip file. You have to agree to the license and usage rules from CMS first before they let you get to the data. The link above points to version A in 2012; CMS usually releases a few revisions through the year, but they usually don’t affect pediatrics and primary care.
  3. Extract the PPRRVU12.xlsx file from the zip file.
  4. Cut and paste the entire page of data from the PPRRVU12.xlsx file into the tab marked “PPRRVU12” in the RVU Calculator spreadsheet (the one you downloaded in step 1). It is a big file, so be patience.
  5. Choose your locality with the pull down menu.
  6. Pick a Medicare Multiplier.
  7. Then, enter your top CPT codes in column A.
  8. Put some unit volumes (how many times your practice performed the code), prices, and payments in and watch what happens. Any field marked in a light blue-gray is a place where you can enter info.
Heads up –  I encountered a few minor issues with the Excel sheet that I wanted to warn you about. Sometimes, Excel converts many of the cells into ‘text’ fields. Even though you see a number (ie 99213), Excel thinks it is a word. The sheet has all kinds of fancy formulas. And those formulas are looking for numbers, such as 99213, not letters. So have that in mind when using the tool.  If you don’t know how to change text into numbers in an Excel cell, check out this link.

I want to thank Chip Hart from PCC for creating this gem and for letting me share it with you all. Talk about sharing the love.

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