Most services provided by pediatricians are paid for on a fee-for-service basis. Fee-for-service payment is typically based on the Medicare Physician Fee Schedule (MPFS), including relative value units (RVUs) assigned to procedure codes and a conversion factor or dollar amount paid per RVU. (Medicare payment is also affected by geographic practice cost indexes that may increase or decrease the RVUs assigned to codes.) Both RVUs and conversion factors are subject to change annually in the updates to the MPFS. In 2018, the conversion factor for the MPFS is $35.99 (35.9996). The conversion factor for 2019 is proposed to be $36.05 (36.0463). Anesthesia services (general and monitored anesthesia, deep sedation) are paid with a separate conversion factor proposed at $22.30 (22.2986) per anesthesia unit for 2019.

Note that not only the conversion factor changed; the RVUs for many services are also slightly increased or decreased. Keep watch on your payer contracts...

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