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While the 2018 editions of the ASA Relative Value Guide® (RVG) and CROSSWALK® will soon be available, many anesthesia practices are asking about the RVG base unit values to be assigned to the five new codes that will describe anesthesia for GI endoscopy in 2018. In its final rule for the CY 2018 Medicare Physician Fee Schedule, the Centers for Medicare & Medicaid Services (CMS) accepted ASA’s recommendations for four of these five codes. CMS decreased the base units for screening colonoscopy to three base units (00812). ASA strongly disagrees with this decision. Our member survey data supports four units, and our Relative Value Guide (RVG) will reflect four units. See Table 1 for details.
ASA President James Grant, M.D., M.B.A, FASA stated in his November 13, 2017 Monday Morning Outreach to ASA members, “Differing values in the RVG and CMS are not common, but when ASA strongly disagrees and has survey data to support our position, ASA will be transparent and make the appropriate notations in the RVG.” Dr. Grant further noted that, “The process of assigning values to codes is very complex with multiple layers. Probably one of the key components are the surveys sent out to clinicians. If you should ever get a survey, please take the time to review it and give us appropriate and thoughtful responses. All the processes leading up to CMS valuation take the surveys very seriously and often are the major criteria in the code value assignment process.”
ASA convinced CMS not to change its process of updating the professional liability component of the overall fee schedule - a change that would have decreased the Medicare anesthesia conversion factor - a negative impact on all anesthesia services. ASA’s success on this issue culminated with an INCREASE to that conversion factor. The 2018 Medicare Anesthesia Conversion Factor increases from $22.0454 to $22.1887. The Medicare Anesthesia Conversion Factor undergoes geographic adjustments. Locale-specific Medicare anesthesia conversion factors are available here.
