Fall 2016: Volume 72, Number 2
DO RUC SURVEYS MATTER?
By Debra Lansey, MPH
APA Office of Health Care Financing
In short, yes, they do. They matter very much.
Why? Because the American Medical Association’s RUC (short for Relative Value Scale Update Committee) provides information to the Centers for Medicare and Medicaid Services (CMS) for the Medicare fee schedule. The fee schedule is the basis for payments to psychologists and other practitioners in the Medicare program. Even more important for the average practitioner, the Medicare fee schedule frequently sets the bar for the fee schedules of commercial health insurers, too.
The AMA’s RUC surveys are the primary vehicle used by specialty societies like APA to advocate for appropriate values in the Medicare fee schedule. For every CPT code that psychologists use, there is a relative value connected to it. The relative values are the result of recommendations that APA Office of Health Care Financing (OHCF) makes based on data collected from our members, in the RUC surveys.
RUC surveys are conducted because either a) CMS has required that a service’s relative value be carefully reviewed by the specialty performing the service, or b) the specialty society has determined that there is sufficient evidence that the relative values need to be reviewed for potential updates. Either way, the specialty society has to collect data from people in active practice – by way of standardized surveys developed and administered by the AMA RUC.
The compiled data from survey responses become the basis of the arguments for adjusting the relative values. If you are asked to complete a RUC survey, it’s critical that you do it.
OHCF is actively involved in the RUC process and regularly comments on initiatives underway in the RUC process and in the Medicare fee schedule process. They advocate for psychology’s tangible value to the Medicare system.
To help you understand how the RUC process works, OHCF has posted a PowerPoint presentation showing the flow of the RUC process; it can be viewed here http://www.apapracticecentral.org/reimbursement/ruc-survey-presentation.pdf.
If you have questions about the RUC process or about the Medicare fee schedule, please contact the APA Office of Health Care Financing at firstname.lastname@example.org.