Question

Payers other than Medicare use RBRVS as the foundation for their physician fee schedules. However, most reimburse at a higher rate than Medicare. How do payers accomplish this adjustment to the payment amount?

a) Increased Copayments
b) Higher Deductibles
c) Multiplier Adjustment
d) Bundled Payments

Answer 1

Payers use a Multiplier Adjustment to reimburse at higher rates than Medicare by applying a factor that increases the reimbursement rate for services provided based on the RBRVS system.

Step-by-step explanation:

Payers other than Medicare use the Resource-Based Relative Value Scale (RBRVS) as the foundation for their physician fee schedules. To adjust the payment amount to be higher than Medicare's rates, payers typically use a Multiplier Adjustment. This involves applying a factor that increases the reimbursement rate for services provided. For instance, if Medicare reimburses at a rate of $100 for a specific service, another payer might use a multiplier of 1.2, which would result in a payment of $120 for the same service. This allows for reimbursement at a higher rate without changing the structure of the RBRVS itself.