Following is a summary of changes made to the 2012 Centers for Medicare & Medicaid Services (CMS) Medicare Resource-Based Relative Value Scale (RBRVS) and how they pertain to Current Procedural Terminology (CPT®) codes reported by pediatricians.

The CMS agreed with American Medical Association/Specialty Society Relative Value Scale Update Committee (RUC) recommendations and set Medicare relative value units (RVUs) as follows:

The CMS agreed with RUC recommendations for an increase in physician work RVUs for CPT codes 99381–99384 and 99391–99394 (initial and subsequent preventive medicine visits), and 99460, 99462, and 99463 (initial and subsequent normal newborn care). Note the substantial increase in Medicare physician work RVUs from 2011 to 2012.

The 2012 Medicare conversion factor will be reduced by 27.4% unless changes are made to the sustainable growth rate (SGR). The American Academy of Pediatrics (AAP) has strongly encouraged the CMS to fix the flawed SGR formula. As you are...

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