ISSUES IN THE APPLICATION OF THE RESOURCE-BASED RELATIVE VALUE SCALE SYSTEM TO PEDIATRICS - A SUBJECT REVIEW

In today's rapidly changing health care environment, it is crucial to understand the genesis and concepts of the Medicare Resource-based Rel ative Value Scale (RBRVS) physician fee schedule. Many third-party pay ers, including state Medicaid programs, Blue Cross-Blue Shield agencie s, and managed care organizations are using variations of the Medicare RBRVS to determine physician reimbursement and capitation rates. Beca use the RBRVS fee schedule was originally created for Medicare only, p ediatric-specific Current Procedural Terminology codes and pediatric p ractice expense issues were not included. The American Academy of Pedi atrics agrees with the use of the Current Procedural Terminology codes and the RBRVS physician fee schedule and continues to work to rectify the inequities of the RBRVS system as they pertain to pediatrics.