Resources for Creating and Using Fee and RVU Schedules

All Fee and RVU Schedules can be created in the Fee/RVU Management Library.

The following resources can be found on the CMS website.

• Physicians Fee Schedule: https://www.cms.gov/apps/physician-fee-schedule/license-agreement.aspx#TopOfPage
• Work/Facility RVU Values: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/PFS-Relative-Value-Files

All uploaded files used to create these Schedules must be in csv format and the files must be created exactly as shown below.

• If a file is uploaded, and it contains 0 Items after the upload, you probably did not create the file correctly.
• Follow the instructions below exactly as stated.

Prepare a CSV Document for Upload

Download the CMS Physicians Fee Schedule or RVU Schedule, in Excel format.

• Make the changes to the file as shown below, and save it in a csv (comma delimited) file format.

• The file will not upload in any other format.

• All columns must be deleted except the ones shown below.

If you are creating your own file, use the same instructions below.

Formatting the File

• Three Columns labeled as follows:

• Column A: CPT® (All CAPS)
• Column B: Modifier (First letter capitalize; can leave blank)
• Column C: Fee (Allowed Fees; No $ signs; can be decimals or no decimals)

• Example: 175 or 175.00

• No formatting, such as bold, italics, borders, etc.
  
• No special characters (unless otherwise specified)
  
• No blank rows
• Save the spreadsheet in csv format.

Billing Provider, Facilities, Insurances, and Plans Panels

The check box beside each section in a panel can be used to Include All or Exclude All in that section.

• Example: In the Billing Provider panel, PRV B is unchecked, which un-checks all of the subsections underneath it.
• If the check box is green, it indicates that all Providers are not included.

Use the Collapse link to minimize all subsections in the panel.

Use the Check/Uncheck All to select or deselect all check boxes.

Use the Search Filter in each panel to search specifically.

• Enter a Payer in the Insurance panel search field.
• All sections will open that have that Payer.
• Example: Enter Cigna

• All segments containing Cigna will open along with the subsections.

Section Hierarchy  in the Billing Providers, Facilities, Insurances, and Plans Panels

Each Panel is broken down into these sections and subsections:

Billing Providers

• All Billing Providers

• Billing Provider Groups

• Individual Providers in the Group

• No Reporting Group

• No specialty

Facilities

• All Facilities

• Facility Group

• Individual Facilities

• No Reporting Group

• Individual Facilities

Insurances

• All Insurances

• Insurance Reporting Groups

• Individual Insurances

• No Reporting Group by CFI with Individual Insurances as subsections

• Blue Cross/Blue Shield [BL]
• Champus [CH]
• Commercial Insurance [CI]
• Medicaid [MC]
• Medicare [MB]
• Self-Pay [09]
• Verteran Administration Plan [VA]
• Workers' Compensation Health Claim [WC]
• No CFI

Plans

• All Plans

• Individual Plans