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CMS-1403-FC 34
we used to make BN adjustments to reflect the changes in
the PE RVUs.
Section 133(b) of the MIPPA amends section
1848(c)(2)(B) of the Act to specify that, instead of
continuing to apply the BN adjustor for the 5-Year Review
to work RVUs, the BN adjustment must be applied to the CF
for years beginning with CY 2009. Further discussion of
this MIPPA provision as it relates to the CY 2009 PFS can
be found in sections III. and IX. of this final rule with
comment period.
B. Components of the Fee Schedule Payment Amounts
To calculate the payment for every physician’s
service, the components of the fee schedule (physician
work, PE, and MP RVUs) are adjusted by a geographic
practice cost index (GPCI). The GPCIs reflect the relative
costs of physician work, PE, and malpractice insurance in
an area compared to the national average costs for each
component.
RVUs are converted to dollar amounts through the
application of a CF, which is calculated by CMS’ Office of
the Actuary (OACT).
The formula for calculating the Medicare fee schedule
payment amount for a given service and fee schedule area
can be expressed as: