Up to code: How your reimbursement is connected to billing code values

Psychologists can influence the valuation of codes when they complete a RUC survey.

If you are contacted via email by the Practice Organization to participate in a “Relative Value-Scale Update Committee (RUC) survey,” we urge you to read the email and complete the survey. These surveys give you the chance to provide feedback on how codes for health care services should be valued, and how you and other psychologists should be reimbursed for the psychological services.

We know practicing psychologists nowadays are faced with increasing demands on their time. But taking a RUC survey is an important, valuable and unique opportunity. By agreeing to participate and completing the survey, you will be acting on behalf of your colleagues and representing your entire specialty.

How does the RUC use the surveys?

The American Medical Association (AMA) RUC meets three times a year and is made up of 31 experts, most of whom are physicians. The RUC also has an advisory committee comprised of representatives appointed from each of the 119 specialty societies. As part of our service to APA and Practice Organization members, APA’s advisors to the RUC attend each RUC meeting, and when required, conduct surveys, collect data and present relative value recommendations for services that psychologists provide. The RUC evaluates the services and then makes valuation recommendations to the Centers for Medicare and Medicaid Services (CMS). CMS releases updates to the values of services covered under Medicare, based partially on recommendations from the RUC, in its annual Physician Fee Schedule.

How can psychologists influence the RUC process?

For the RUC survey process to succeed, the cooperation and participation of practicing psychologists is essential. It is only with your input that the APA and Practice Organization can provide the RUC and CMS with accurate data so psychological services can be fairly valued by Medicare. However, it should be noted that many private/commercial insurers also use annually updated Medicare values to rationalize their own fees and policies, resulting in a wide and significant impact of the RUC process.

The survey typically takes 20-30 minutes to complete. As part of the survey, you will be asked to read a description of a Current Procedure and Terminology (CPT®) code and a vignette of the typical patient receiving the procedure. The survey will then ask a series of questions to get your best estimate about the time, intensity and medical decision-making involved in performing the procedure. The responses to these surveys are the evidence that APA uses to develop and support the valuation recommendations presented to the RUC. Without accurate data, we cannot expect to receive appropriate reimbursement for our services.

RUC survey instruments are standardized tools that are used across all specialties. Review the AMA informational video, “Understanding the RUC Survey Instrument- Non-Physician Qualified Healthcare Professionals,” to become more comfortable with the RUC process and survey instrument.

If you have questions about the RUC process or about the Medicare fee schedule, contact the Office of Health Care Financing.

Additional resources