Medicare Physician Fee Schedule

The Centers for Medicare and Medicaid Services (CMS) uses the Medicare Physician Fee Schedule (MPFS) to outline reimbursement rates and policies for physician services. The MPFS is funded by Part B and is composed of resource costs associated with physician work, practice expense and professional liability insurance. ACR^® provides valuable feedback on annual MPFS rulemaking via comment letters, advocating on our members’ behalf regarding issues found in the rule that impact radiology.

Under the MPFS, each of these three elements is assigned a Relative Value Unit (RVU) for each Current Procedural Terminology (CPT^®) code. These RVUs are then adjusted based on the Geographical Practice Cost Index associated with various geographic areas for different medical costs and wage differentials. The conversion factor is the national dollar amount that is multiplied by the total geographically adjusted RVU to determine the Medicare-allowed payment amount for a particular physician service.