Radiology Gets a Smaller Slice of the MPFS Pie

Gregory N Nicola, MD, FACR; Lauren P Golding, MD


Appl Radiol. 2021;50(1):28-30. 

In This Article

New Office Visit Values

Once this CPT coding structure was in place, the next step in revising or newly creating CPT codes is for the RUC to recommend a relative value unit (RVU) for each code. The valuation process employed by the RUC includes a survey of clinicians who perform such encounters; in this case a broad and diverse community encompassing any clinician with face-to-face office visits. Surveys were conducted by medical specialty societies with privileges with the RUC; these included primary care, internal medicine, specialty medicine, and surgical specialties.

Although surgeons, depending on the specific subspecialty, infrequently bill stand-alone E&M codes, many of their core surgical codes contain a global period ranging from 10 to 90 days. These global service periods act like a bundle of services including the core surgical procedure, inpatient postoperative visits, and subsequent outpatient office visits, compelling the surgical specialties to participate in the valuation process. The results of the survey sent CMS a strong signal that the outpatient E&M codes were viewed as undervalued and worthy of significant RVU increases.