Current Procedural Terminology (CPT), the coding system for services pediatricians furnish, is closely linked to reimbursement through the resource-based relative value scale (RBRVS), which was developed by the Centers for Medicare and Medicaid Services (CMS) (formerly the Health Care Financing Administration [HCFA]) and adopted for Medicare physician payment in 1992. It has subsequently been regarded as the most generally accepted scale of relative physician reimbursement. The RBRVS takes into account the following 3 components: (1) the amount of physician work that goes into the service, (2) the practice expense associated with the service, and (3) the professional liability expense for the provision of the service. The RBRVS has been through 2 5-year review refinements with physician input. It is now used, in some form, by most payers, including most state Medicaid programs.

The RBRVS has been widely regarded as a system that has established parity between cognitive specialties, such as...

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