Editor’s note: Dr. Vanchiere died Jan. 28 after suffering a stroke. Following is an abridged version of an article that appeared in The Pediatric Coding Companion, a quarterly supplement to the AAP Coding for Pediatrics book.

The Health Care Financing Administration (HCFA) implemented the RBRVS physician fee schedule on Jan. 1, 1992, which replaced the Medicare physician payment system of “customary, prevailing and reasonable” (CPR) charges. Under the old CPR system, physicians were reimbursed according to the historical record of the charge for the provision of each service. Since implementation of the RBRVS, some physicians have slowly converted their fee schedule to an RBRVS-based schedule. RBRVS, as the basis for fee schedules and physician reimbursement, is as important to pediatricians as it is to other physicians. It should “level the playing field.” It is important for pediatricians to understand RBRVS, because many third-party payers are utilizing variations of the Medicare...

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