Calculate Fees Differently in 2009 Here's how the BNA adjustment and the new conver-sion factor will change your reimbursement in 2009: 2008 way:
Example: Here's how Medicare computed the fee for 76511 in 2008 (assuming a GPCI of "1"):
0.94 work RVUs x 0.8806 BNA (rounded) = 0.83
0.83 x 1 GPCI = 0.83
1.89 PE RVUs x 1 GPCI = 1.89
0.1 malpractice RVUs x 1 GPCI = 0.1
0.83 + 1.89 + 0.1 = 2.82
2.82 x 38.0870 = $107.41.
2009 way:
In 2009, Medicare payers will no longer apply the BNA adjustment to only the work RVUs. CMS is applying the BNA directly to the conversion factor, which is one reason it's down to 36.0666. Payers will simply adjust the work, PE, and malpractice RVUs for GPCI, add the results together, and multiply that sum by the conversion factor to arrive at the payment for a procedure.Example: Again, assuming a GPCI of "1," here's the fee for 76511 in 2009:
0.94 work RVUs x 1 GPCI = 0.94
1.63 PE RVUs x 1 GPCI = 1.63
0.1 malpractice RVUs x 1 GPCI = 0.1
0.94 + 1.63 + 0.1 = 2.67
6.00 x 36.0666 = $96.30.