Prompted by the 2007 national work RVU increases for the specialty of emergency medicine, the Michigan College of Emergency Physicians has advocated fee increases for its members. It has leveraged the national trend to receive an average 18% increase in E/M codes 99281, 99282, 99284 and 99285, effective July 1, 2008.
The College’s Health Finance Committee, which meets quarterly with representatives from Blue Cross and Blue Shield of Michigan, began discussing Michigan’s ED fee schedule last year when CMS announced RVU increases and subsequent increases in reimbursement for emergency providers. Initially, BCBS of MI did not embrace the national decision to increase reimbursement for Michigan Emergency Physicians. However, the College focused its effort on convincing BCBS that state fee schedules deserved a second look based on the National ACEP’s Reimbursement Committee members’ success with increasing emergency medicine work RVUs.
Objective RVU increases from CMS were the grounds for fair negotiations, and after a year of advocacy, the Michigan Health Finance Committee was awarded an average 18% increase across four of the five most frequently used ED E/M codes (99283 did not receive an increase as RVUs decreased slightly).
This accomplishment stems in many ways from the victory our colleagues at National ACEP experienced at the National RUC (where work RVUs are discussed). Their abilities to convince CMS, our nation’s largest single payer, of the increased work value inherent to emergency medicine, was the driving factor to success at the state level.
# # #