The Primary Care Compensation Paradigm Shift That Was Meant to Be

Author: Kelsi O'Brien, MHSA
Published Date: November 2022

In 2020, the RVS Update Committee (RUC) recommended a significant shift in how primary care services are valued. Facilitated by the American Medical Association (AMA), the RUC assigns relative value unit (RVU) values for new CPT codes, reviews existing codes every five years, and provides RVU recommendations to the Centers for Medicare & Medicaid Services (CMS). The committee is made up of 32 members representing major medical specialty societies and requires a two-thirds vote to make recommendations to CMS. While CMS has the final say, the RUC holds significant influence.

The RUC’s recommendation, later implemented by CMS, introduced changes to RVUs and documentation requirements for outpatient evaluation and management (E/M) codes. These updates will have a lasting impact on medical groups. This white paper breaks down the key changes and the goals behind them.