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首页> 外文期刊>JAMA otolaryngology-- head & neck surgery >Valuation of Commonly Performed Head and Neck Surgical Procedures in the Medicare Physician Fee Schedule
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Valuation of Commonly Performed Head and Neck Surgical Procedures in the Medicare Physician Fee Schedule

机译:Medicare医师费表中常用头颈手术程序的估值

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摘要

The Medicare Physician Fee Schedule (PFS) is widely used by public and private payers to determine clinician reimbursement. The Centers for Medicare & Medicaid Services (CMS) specifies payment rates under the PFS based on relative value units, which account for the resources necessary to provide services, including clinician work, practice overhead, and malpractice expense.1 The number of relative value units allocated for clinician work primarily depends on the amount of time required to provide each service. To understand time requirements, CMS relies on the Relative Value Scale Update Committee (RUC) of the American Medical Association. The RUC has faced criticism for estimating time requirements based on small physician surveys. Recent empirical work has demonstrated that biased data from these surveys may lead CMS to overcompensate certain surgical specialties (eg, orthopedics) and undercompensate others (eg, neurosurgery). Little is known about the potential impact on otolaryngology. We therefore sought to examine the accuracy of PFS valuations of commonly performed head and neck surgical procedures.
机译:医疗保险医师费表(PFS)被公共和私人付款人广泛用于确定临床医生报销。 Medicare&Medicaid服务中心(CMS)根据相对价值单位规定了PFS下的付款率,该单位考虑了提供服务所需的资源,包括临床医生工作,练习开销和医疗事务费用.1相对价值单位的数量为临床医生分配主要取决于提供每项服务所需的时间。要了解时间要求,CMS依赖于美国医学协会的相对价值规模更新委员会(RUC)。 RUC对基于小医生调查估算时间要求面临批评。最近的经验工作已经证明,来自这些调查的偏置数据可能导致CMS过度补偿某些外科专业(例如,骨科),并巩固他人(例如,神经外科)。关于对耳鼻喉科诊断的潜在影响很少。因此,我们试图检测PFS估值的准确性,常用的头部和颈部外科手术。

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