JAMA Network September 23, 2019
In 1992, the Centers for Medicare & Medicaid Services (CMS) introduced the Resource-Based Relative Value Scale (RBRVS) as a new system for physician payment. Rather than paying physicians their “usual, customary, and reasonable”1 charges, this system was designed to pay physicians based on the time, technical skill, and mental effort required to perform each procedure. Thus, the relative value unit (RVU) was born.
Given the detailed medical knowledge required to assign numerical values to each procedure, the American Medical Association formed the Relative Value Scale Update Committee (RUC) to assist CMS with assigning and updating RVU values. Today, the RUC has become sufficiently integral to the RVU updates that its recommendations are accepted without change by CMS more than 90%...
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