Double Check wRVUs

Work RVUs (wRVUs) are commonly used to measure physician productivity, accounting for the technical skills, physical effort, mental effort, judgment, and the amount of time required to perform a given service or procedure. Under many physician compensation plans, a physician is paid a specific dollar amount per wRVU generated. Significant amounts of money may be tied to wRVUs, so it is important that health systems and physicians have confidence that wRVU totals accurately reflect the professional work being done by each individual physician.

For the benefit of all parties, a good practice to adopt is periodically auditing wRVU inputs and related data to help ensure physicians are being paid appropriately. The table below summarizes specific data to review in order to thoroughly assess and address any areas of concern in wRVU accounting. For more information or hourly consulting, contact us.

Data to Review	What to Look For
Physician wRVU History	Significant fluctuations in year-to-year wRVU levels without a reasonable explanation
Survey Data	wRVUs in the top or bottom deciles; collections/wRVU and wRVUs/encounter in the top or bottom quartiles
Internal Peer Group Data	wRVUs, collections/wRVU, wRVUs/encounter that are in the top or bottom quartiles
Non-Physician Providers	Indication that physicians are receiving credit for services (including services billed incident-to) performed by non-physician providers
Modifiers	Modifier-related adjustments to wRVUs and proper usage of modifiers that impact reimbursement
wRVU Inputs	Use of the correct Medicare Physician Fee Schedule (published at least annually) and the right set of RVUs (out of 4 possible)
Dates of Service	Use of 12-month data or properly-annualized data
Physician Schedules	Services provided when physicians are not on schedule or not working at the indicated facility
Bell Curves	Physician E&M code distributions that look significantly different from Medicare averages for the specialty.
Top 25 Procedures	Procedures that don’t match the specialty; utilization that looks unreasonable given the specialty/time needed to perform the service.