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<strong>CMS</strong>-1403-FC<br />

(iv) Calculate the Final PE RVUs.<br />

Step 18: Add the direct PE RVUs from Step 6 to the<br />

indirect PE RVUs from Step 17.<br />

Step 19: Calculate and apply the final PE BN<br />

adjustment by comparing the results of Step 18 to the<br />

current pool of PE RVUs. <strong>This</strong> final BN adjustment is<br />

required primarily because certain specialties are excluded<br />

from the PE RVU calculation for rate-setting purposes, but<br />

all specialties are included for purposes of calculating the<br />

final BN adjustment. (See “Specialties excluded from<br />

rate-setting calculation” below in this section.)<br />

(v) Setup File Information<br />

• Specialties excluded from rate-setting calculation:<br />

For the purposes of calculating the PE RVUs, we exclude<br />

certain specialties such as midlevel practitioners paid at<br />

a percentage of the PFS, audiology, and low volume<br />

specialties from the calculation. These specialties are<br />

included for the purposes of calculating the BN adjustment.<br />

• Crosswalk certain low volume physician specialties:<br />

Crosswalk the utilization of certain specialties with<br />

relatively low PFS utilization to the associated<br />

specialties.<br />

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