Thursday, September 5, 2019

Very Brief Blog: AMA Publishes Detailed RUC Minutes

Here's something new.   AMA conducts elaborate meetings of its RUC (relative valuation) committee, passes those recommendations to CMS, which heavily influence the assignment of CMS values and pricing to CPT codes. 

Very lengthy minutes are left behind online.   The RUC Minutes home page is here:

This either requires no registration or an email registration.  For example, the May 2019 RUC minutes are 376 pages of detail:

The January 2019 minutes are 2894 pages of detail:

Separately, through the AMA Store, AMA sells online annual subscriptions for $320 to the RUC RBRVS Database, which gets you into definitions, RUC decisions, valuation, and utilization of every CPT code.   Search AMA Store for "RBRVS Data manager Online."  (One version here.)


online resources run back several years

over 300 pages of info for this RUC meeting; a different one is 2800 pages


There's a 2018 paper by Gao et al. that suggests specialties do better financially when they have RUC representation, although the effect is small.  Gao et al., 2018 (PMID 29633250).  It's discussed in an Op Ed article by Laugensen, 2018 (PMID 30421423).  Therein, she cites a news article by Robeznieks, 2013, that AMA had just begun posting RUC minues (here).  Laugesen also wrote a major book on the RUC, Fixing Medical Prices (here).

Other AMA Resources for Reimbursement

CPT Panel Actions
After CPT meetings, with a delay of a few weeks, AMA publishes a brief table whether each code agenda item was approved, disapproved, or tabled.  AMA calls this "Summary of [CPT] Panel Actions."  See here.  May 2019 is here.

AMA Meetings Confidentiality Statement
If of interest, an AMA CPT confidentiality statement sample is here.  It's aimed primarily as protecting AMA CPT copyright interests.

2012 Memories: Collusion
In 2012, when AMA RUC produced valuations for molecular testing (which ended up on the Clin Lab fee schedule not the RVU-based fee schedule), AMA did not release those RUC valuations.  I understood at the time (and I'm not an AMA insider) this was because AMA wanted to avoid any possibility of what might look like mass price-setting or collusion, etc.  (But it was OK if CMS published the same values in Federal Register.) 

CMS gets around this by holding the RUC minutes UNTIL the CMS proposed rule publishes.  For example, RUC minutes for Jan 2020 won't be published til July 2020 when CMS publishes.  Cool.