The American Medical Association (AMA) Relative Value Update Committee (RUC) is seeking input from ACR members about physician work and practice expenses that affect rheumatologists and rheumatology practices. If you have been contacted by the ACR via email to participate in a RUC survey and have experience performing the indicated Current Procedural Terminology (CPT) code, we strongly encourage you to complete the survey. Data from these surveys play a key role in how Medicare and other health insurers set reimbursement rates.
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The AMA RUC comprises 32 physicians and other volunteer healthcare professionals who work with medical societies to make recommendations to the federal government about resources required to provide medical services. The RUC meets three times per year and closely coordinates with the AMA CPT Editorial Panel on annual code revisions related to updates in the Medicare Physician Fee Schedule.
The RUC is tasked with evaluating hundreds of services across the house of medicine and relies heavily on the expertise of the medical societies and healthcare professionals from many specialties to provide input on patient care services. The RUC has established a high bar for its methodology to increase accuracy, efficiency and transparency and to collect the most reliable and robust data possible. The AMA surveys members of specialty societies to obtain specialty-specific expertise from practicing providers on physician work and practice expenses.
When services performed by rheumatologists fall in the CPT/RUC queue, ACR RUC advisors and staff may seek input to determine the appropriate value for these services. This information is usually collected through the AMA RUC survey about the time and intensity required to perform those services. These surveys are important to the business of rheumatology, because the results can inform Medicare and other payer reimbursement rates.
Current Codes Under Review
The ACR is currently participating in two RUC surveys on physician work and practice expenses that are vital to the business of rheumatology. Earlier in 2021, ACR members contributed to four multispecialty RUC surveys that included the outpatient consultation codes (99242–99245), prolonged services and/or after direct patient care (99358–99359), the new prolonged codes (99417 and 993X0) and the diagnostic ultrasound codes (76881 and 76882).
Keep in mind that the AMA process and guidelines are critical to the collection and use of the data and the link should not be shared with anyone else. If you have been contacted by the ACR to participate in a RUC survey and have experience performing the selected CPT code, we strongly encourage participation to assist with the RVU proposals. Unfortunately, insufficient respondents to a surveyed code can cause a code to lose value or require societies to undertake the tedious process of resurveying the codes, which can delay code valuation.