1. AMERICAN COLLEGE OF CHEST PHYSICIANS “Improving Patient Care Through Education” Survey Participation Is Integral to Your Success: AMA/Specialty Society RVS Update Committee (RUC) Survey Burt Lesnick, MD, FCCP ACCP RUC Advisor November 2013

2. Survey Participation Is Integral to Your Success: AMA/Specialty Society RVS Update Committee (RUC) Survey Discussion Topics: Frequently asked questions about surveys Purpose of a survey Important survey concepts What’s next? Questions 2 of 10

3. Survey Participation Is Integral to Your Success: AMA/Specialty Society RVS Update Committee (RUC) Survey Frequently Asked Questions About the Survey: 1.Why is this survey being conducted? 2.How is this survey different from other member surveys? 3.Will participant name and response be held in confidence or shared? 4.What is the purpose of the financial disclosure section? 5.Can any work on the survey be saved to come back to it later? 6.How long do I have to complete the survey? 7.Why is the RUC survey important to complete? 3 of 13

4. Survey Participation Is Integral to Your Success: AMA/Specialty Society RVS Update Committee (RUC) Survey Purpose of a Survey: Adequately evaluate the relative value units (RVUs) of physician work, direct practice expense (clinical staff time, supplies, and equipment), and malpractice expense. Surveys probe the level of:  physician physical effort  technical skill needed to perform services  time in providing service  medical effort  medical judgment  stress 4 of 13

5. Important Survey Concepts: RUC recommendations to CMS are made from analysis of data collected via specialty society members, just like you! All the areas a survey probes have value and are accounted for in assigning an RVU to a procedure. The survey will ask you to compare the time, complexity of work, and effort level of one procedure in comparison to others via a reference service list (RSL). Respond to the survey as if you are doing what is considered “typical,” from the standards of the vignette. 5 of 13 Survey Participation Is Integral to Your Success: AMA/Specialty Society RVS Update Committee (RUC) Survey

6. Important Survey Concepts: Definitions Reference service list (RSL) - the survey includes a list of procedures that have been selected for use as comparison for this survey because their relative values are sufficiently accurate and stable to compare with other services. Select a procedure from the list that is most similar in time and work to the new/revised CPT code descriptor and typical patient/service described. Reference procedure does not have to be equal in work in your judgment to the surveyed procedure but it should be similar in work. Survey Participation Is Integral to Your Success: AMA/Specialty Society RVS Update Committee (RUC) Survey 6 of 13

7. Important Survey Concepts: Definitions Time Estimate - Using the vignette and the description of service periods, this section of the survey asks you to estimate how much time it takes you when you perform the procedure/service. These estimates should be based on your personal experience and the typical patient identified in the survey. Vignette - This is a short description of the typical patient receiving the procedure being surveyed. 7 of 13 Survey Participation Is Integral to Your Success: AMA/Specialty Society RVS Update Committee (RUC) Survey

8. 8 of 13 Important Survey Concepts: Definitions Pre-service Period - The pre-service period includes physician services provided from the day before the procedure or service until the time of the procedure or service. Intra-service Period - The intra-service period includes all “skin to skin” work that is a necessary part of the procedure. Post-service Period - Post-service period includes physician services provided on the day of the procedure until the time after the procedure has been performed. Survey Participation Is Integral to Your Success: AMA/Specialty Society RVS Update Committee (RUC) Survey

9. 9 of 13 Survey Participation Is Integral to Your Success: AMA/Specialty Society RVS Update Committee (RUC) Survey Important Survey Concepts: Definitions

10. 10 of 13 Survey Participation Is Integral to Your Success: AMA/Specialty Society RVS Update Committee (RUC) Survey What is not physician work - Physician work does not include services provided by support staff who are employed by your practice and cannot bill separately, including: Registered nurses Licensed practical nurses Medical secretaries Receptionists Technicians Important Survey Concepts: Definitions

11. 11 of 13 Survey Participation Is Integral to Your Success: AMA/Specialty Society RVS Update Committee (RUC) Survey Estimate the Work RVU - In this final step you will be asked to estimate the work RVU. You are asked to consider the value assigned to the reference procedure in developing your estimate. The survey methodology attempts to set the work RVU of the procedure “relative” to the work RVU of the comparable and established reference procedure. Important Survey Concepts: Definitions

12. Survey Participation Is Integral to Your Success: AMA/Specialty Society RVS Update Committee (RUC) Survey What’s next? When you receive the link to complete the survey: Review the code descriptor and vignette. Pick your reference service code from the RSL to compare with the code being surveyed. Adequately estimate the time spent with patient to perform procedure. Include pre-service, intra-service, and post-service. Complete the survey, with the vignette in mind. (Although you may comment the vignette is not a typical case.) Estimate the work RVU. 12 of 13

13. 13 of 13 Survey Participation Is Integral to Your Success: AMA/Specialty Society RVS Update Committee (RUC) Survey Questions, Comments, Concerns… Contact: JeAnna Stovall, MSA, RHIA Chest Regulations & Reimbursement Director jstovall@chestnet.org