RBRVS Fee Schedules are Now Easy to Create!

RBRVS "relative value units" (RVUs) as well as CPT® and HCPCS codes are easier to use than ever before! The RBRVS is Medicare's "resource-based relative value system." Using Physician's Fee Schedule Software ("PFSS"), you can create fee schedules that are accurate and consistent with the RBRVS. PFSS includes all of the CPT® and HCPCS codes (over 10,000 of them!). PFSS is perfect for physicians, hospitals, clinics, managed care HMOs, PPOs, IPAs, and TPAs, health plans, accounting, actuary, and billing firms, health care reimbursement experts, and anyone else who uses the RBRVS to manage medical reimbursement. Do you create non-medicare fee schedules? PFSS handles non-Medicare fee schedules as easily as it does Medicare fee schedules! PFSS is surprisingly affordable, too! Click on the links below to find out more about PFSS!

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What is PFSS? Why Should I Choose PFSS? PFSS Primary Care 2008   How to Order Try the Demo! The RBRVS PFSS Users' Forum Send us Your Feedback

Physician's Fee Schedule Software ("PFSS") is the software professionals use to create physician compensation systems that include:

• RBRVS-based fee schedules for physician services performed in their offices or in hospitals and other facilities;
• Fee schedules for lab tests, supplies, drugs, and services in the HCPCS system.
• PFSS Version 9.0 for 2008 consists of eleven Microsoft Excel files:

1)  ANESTHESIA - Fee schedule for anesthesia services.   Unlike medical and surgical procedures, anesthesia does not use GPCIs.  Instead, different localities use different conversion factors, a list of which is provided in the Manual.

2)  CLINICAL LAB - Fee Schedule for clinical lab procedures based on 2008 National Limits established by Medicare.  Users can un-hide columns that include numbers for their locality or use the National Limit column.  Alternatively, one can ignore this file and use the clinical lab RVUs established by RVSI in the FACILITY and OFFICE files.

3)  CMS PHYSICIAN RVUs 2008 - This is the complete CMS relative value unit database for 2008.  It is included so you can create custom files.

4)  DME AND SUPPLIES - Fee Schedule for pricing of HCPCS denominated supplies and services based on CMS 2008 fee schedule: prosthetics, orthotics, and supplies; parenteral and enteral nutrition items and services.

5)  DRUGS AND VACCINES - This file is based on the CMS files for drugs called the ASP files (average sales price) published on the CMS website, effective January 1, 2008.

6)  FACILITY - Fee Schedule file for Facility pricing.  In this file are procedures performed by physicians in non-office settings such as hospitals, outpatient surgery center, and nursing homes.

7)  HEADER TEMPLATE - This header is supplied to assist you with creating custom spreadsheets.  It contains the formulas that are present in the OFFICE and FACILITY files.

8)  OFFICE - Fee Schedule for Non-Facility pricing.  In this file are procedures performed by physicians in medical offices.

9) RADIOLOGY CAPS - This file contains the capped payment amounts for the technical component and the global fee for diagnostic imaging procedures as published on the CMS website, effective January 1, 2008.

10) RVSI 2008 DATABASE - This is the complete Relative Value Studies, Inc. ("RVSI") relative value unit database for 2008.  It contains RVUs for approximately 950 more procedures than the Medicare one.  Like the former, it is included so you can create custom files.

11) SURGERY - CPT^® codes, nomenclature, professional and technical component indicators, global days, pre-op, intra-op percentages, multiple procedure rules, bilateral surgery rules, assistant and co-surgeons, team surgery, and endoscopic base codes.

Version 9.0 also includes:

Adobe Acrobat Reader Version 6.0, in case you need it A Manual that covers the following topics:

Introduction Computer and Software Specifications Installation instructions An explanation of the Resource Based Relative Value System File Contents, a description of the following files:

Anesthesia Clinical Lab CMS Physician RVUs 2007 DME and Supplies Drugs and Vaccines Facility Header Template Office Radiology Caps RVSI Database Surgery

Elements of a Fee Schedule Column Definitions Hidden Columns More Column Definitions Conversion Factors for medical and surgical procedures and for anesthesia, for every locality in the United States GPCIs:  geographic price cost indices for every locality in the United States Using PFSS:

Introduction Loading Files Data Entry Points Creating Fee Schedules Changing Nomenclature Changing RVUs Creating Customized Files Saving Files Printing Conversion to Other Formats Medicare's Charge Rules Welcome to the PFSS Users' Forum

COMPUTER SPECIFICATIONS

The following are the minimum required specifications you need to run PFSS:

• IBM PC or 100% compatible Pentium class computer
• 32 Megabytes of Random Access Memory (RAM)
• 15 MB of free hard disk space
• CD-ROM drive
• Color Monitor

SOFTWARE SPECIFICATIONS

• Microsoft Windows XP, ME, or 98
• Microsoft Excel 1997, 2000 or newer for Windows
• Lotus 1-2-3, Release 9/Mellenium Edition or newer

More relative value units than other products thanks to our licensing agreement with Relative Value Studies, Inc.

• Includes Medicare's RVUs plus 950 other CPT^® codes with relative value units
• Separate physician fee schedules for in-office and non-office-based services;
• HCPCS fee schedules for durable medical equipment and supplies
• 2 ways to calculate clinical lab test fees

It includes formulas that allow easy creation of fee schedules for physician services, clinical lab tests, and durable medical equipment and supplies

It's formatted as MS Excel spreadsheets for easy use by anyone with MS Office

A comprehensive manual explains it all and provides GPCIs and anesthesia conversion factors for every part of the US

It's economical

Annual revisions are available when they're needed:  between mid-December and early January of each year

PFSS users have access to the Forum...a web-based bulletin board for compensation system creators and negotiators

PFSS is easy to use.  Geographic modifiers for all U.S. locations are included. Simply insert the modifiers you need, enter a conversion factor, or leave the Medicare CF in place and select a "percent of Medicare." That's all there is to it.

PFSS is used by well known IPAs, HMOs, insurers, physician-hospital organizations (PHOs), and group practices throughout the United States.

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2008

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	Order online with credit card. Click here.
	To order by phone, call: (303) 320-8686
	To place an order by fax, fax your order form to: (303) 320-1828	Print out the order form, fill it in, and then mail or fax it to us!
	To place an order by mail, send your request to: FCMC Professional Software 1340 Leyden St. Denver, CO 80220
	For more information on PFSS, just send an e-mail message to: info@pfss.com

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The RBRVS

History of the RBRVS

The Resource-Based Relative Value Study ("RBRVS") was developed in 1991 for Medicare. It is a system of physician compensation that is based on the amount of resources expended to produce medical services. Work, overhead, and malpractice units ("RVUs") are assigned to medical and surgical procedures as measures of their value. Geographic modifiers ("GPCIs") are then employed to account for variations in costs in different parts of the United States. The sum of these unit values is then multiplied by a conversion factor chosen by the user.

Unlike its predecessors, the RBRVS is not a normative study in that it does not look at what physicians are charging for their services. Instead, it assigns values based on the human and financial resources consumed in the delivery of each procedure.

The RBRVS has become more than a Medicare fee schedule. It is now a system of physician compensation that includes fees for in-office procedures, different fees for hospital, nursing home, and ambulatory surgery center procedures, and rules governing global days, division of fees between pre-op, intra-op, and post-op services, and which procedures qualify for assistant surgeons and co-surgeons.

Each year has seen RBRVS changes in practice expense RVUs, work RVUs, malpractice RVUs, and GPCIs. The trend since its inception has been to pay higher fees for cognitive services and to reduce overpriced surgical procedures without raising the total cost of medical and surgical services.

HMOs and PPOs now base their payments on Medicare's RBRVS-based fee schedule. Offers of 120 to 150 percent of Medicare are commonplace. PFSS, which incorporates the RBRVS and its surgical rules, is the software system employed by managed care plans and groups of physicians throughout the United States. It contains 11 separate programs for calculating physician fee schedules for procedures provided in offices, fee schedules for procedures provided in other locations, supply and ancillary service ("HCPCS") fee schedules, surgical services, and clinical lab tests. It is the most comprehensive, yet easy to use, fee schedule software available. RBRVS changes and enhancements are included in annual revisions.  More than 950 "gap" codes are assigned values - i.e. the codes Medicare does not assign RVUs now have them thanks to our agreement with Relative Value Studies, Inc.

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This web page copyright © 2003-2008 by: FCMC Professional Software 1340 Leyden Street Denver, CO 80220

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