Reader Questions:
No MPFS RVW Means No Medicare Coverage
Published on Tue Apr 19, 2011
Question:Can you explain to me why some codes (such as 99172) do not have an associated relative value unit (RVU)? How can I find what the RVU's are for this code?California Subscriber Answer:RVUs are based on the Medicare Physician Fee Schedule; if a CPT procedure code does not have an RVU, it usually is because Medicare does not cover the service. Or, even if CMS does cover the service, some of your other payers might not. For example, the California worker's compensation program does not follow RVUs in general, so it has its own codes and payment schedule. Options: Check some of your other payers' fee schedules to determine an appropriate price for the procedure. Some might allow separate payment, while some could consider procedures such as 99172 (Visual function screening, automated or semi-automated bilateral quantitative determination of visual acuity, ocular alignment, color vision by pseudoisochromatic plates, and field of vision [...]
