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Understanding the RUC Survey Instrument: Surgical Services

Gain a comprehensive understanding of the RUC survey instrument for surgical services, including its basics, purpose, stakeholders, and simple steps. Learn why these surveys are conducted and how they contribute to accurate payment and representation. Obtain estimates of procedure time, visits, and complexity, as well as professional work value. Engage with survey stakeholders such as the AMA/Specialty Society RVS Update Committee and professional societies/associations. Follow the survey's simple steps, which include reviewing code descriptors and vignettes, completing contact information, identifying a reference procedure, estimating time and work RVU, and comparing the survey procedure to the chosen reference procedure.

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Understanding the RUC Survey Instrument: Surgical Services

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  1. Understanding the RUC Survey Instrument: Surgical Services

  2. Understanding the RUC Survey • Survey basics • Survey purpose • Survey stakeholders • Survey simple steps

  3. Understanding the RUC Survey • Survey basics • Survey purpose • Survey stakeholders • Survey simple steps

  4. Why are the surveys being conducted? • Accurate and fair payment • Representation from practitioners • Information for the Centers for Medicare and Medicaid Services

  5. Understanding the RUC Survey • Survey basics • Survey purpose • Survey stakeholders • Survey simple steps

  6. What is the purpose of this survey? • To obtain estimates of procedure time, visits and complexity • To obtain estimates of professional work value

  7. Understanding the RUC Survey • Survey basics • Survey purpose • Survey stakeholders • Survey simple steps

  8. Survey Stakeholders • AMA/Specialty Society RVS Update Committee (RUC): • Oversee survey process of codes. • Makes recommendations to CMS. • Professional Societies and Associations: • Coordinate process for respective professions. • Distribute surveys to members to obtain data. • Submit a summary of survey results and recommendations to the RUC.

  9. Survey Stakeholders • RUC recommendations are sent to CMS following each RUC meeting. • RUC Recommendations are confidential until CMS publication of the Proposed Rule in July. • Values go into effect in January of the following year.

  10. Understanding the RUC Survey • Survey basics • Survey purpose • Survey stakeholders • Survey simple steps

  11. Survey Simple Steps • STEP 1 – Review code descriptor and vignette • STEP 2 – Complete contact information • STEP 3 – Identify a reference procedure • STEP 4 – Estimate your time • STEP 5 – Compare the procedure being surveyed to a reference procedure • STEP 6 – Estimate work RVU (relative value unit)

  12. STEP 1: Review code descriptor & vignette • Review the descriptor and vignette of the procedure being surveyed. • The vignette describes a typicalclinical scenario for the procedure. • Complete the survey instrument using the typical patient described in the vignette.

  13. STEP 2:Complete contact and financial disclosure • Although contact and basic practice demographic information is collected, only aggregate summary data is shared with the RUC. • You will also be asked several financial disclosure questions. • Contact your specialty society with any questions.

  14. STEP 3: Identify a reference procedure • Review the list of reference codes. • Select a reference code that is most similar in time and work to the survey code. • Procedure codes can have different global periods. A procedure paid on a global basis includes: • Visits and other services provided within 24 hours prior to the procedure; • Performing the procedure; and • Post-procedure visits for a specified number of days after the procedure is performed.

  15. STEP 4: Estimate your time • Review the service period definitions included in the survey instrument. • Estimate the time it takes to perform the procedure under review.

  16. Service Period Definitions: • Pre-service: • Includes physician work provided before the onset of the procedure. • Intra-service: • All necessary “skin-to-skin” or “scope in-to-scope out” work.

  17. Service Period Definitions: • Post-service: • BEGINS after the wound(s) are closed or the endoscope is removed. • ENDS based on the global period • A procedure with a 0-day global indicator includes 0 days of post-operative work, while a procedure with a 10 or 90-day global indicator includes 10 or 90 days of post-procedure work • Unrelated procedures or services performed by the same physician during the postoperative global period are not included in the work of the procedure because they can be reported separately.

  18. STEP 5: Compare the survey procedure to your chosen reference procedure • Compare the complexity and intensity of the survey procedure to your chosen reference procedure • much less? • somewhat less? • identical? • somewhat more? • much more?

  19. STEP 6: Estimate work RVU • Estimate the work relative value unit (RVU). • Use your chosen reference service for guidance. • Your work RVU estimate for the survey procedure should be “relative” to the work RVU of your reference procedure, as well as the other codes included in the reference service list.

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