1. ©2012 National Association of Social Workers. All Rights Reserved. ‹#› Completing the RUC Survey Instrument for Psychotherapy Services 2012

2. Purpose of Survey To obtain estimates of time and complexity required in performing a psychotherapy service. To obtain estimate of a recommended professional work value. To determine the rate at which Medicare and other third-party payers reimburse for psychotherapy services. ©2012 National Association of Social Workers. All Rights Reserved. ‹#›

3. How the Survey Works A list of reference services is provided for comparison purposes. The survey asks you to compare a reference service code to an existing code using time, complexity, and work to perform psychotherapy services. It is helpful to print the survey instrument and the reference service list so you can use them side by side while completing the survey. ©2012 National Association of Social Workers. All Rights Reserved. ‹#›

4. INSTRUCTIONS - Step 1 Review introduction of survey. Complete contact information which is confidential. Complete financial disclosure which excludes any financial interest received in the course of providing patient care for your solo or group practice, or facility. ©2012 National Association of Social Workers. All Rights Reserved. ‹#›

5. INSTRUCTIONS - Step 2 Review Code Descriptor and Vignette The vignette describes a typical clinical scenario for the psychotherapy service. Complete the survey using the typical patient described. Continue with the survey if this is or is not your typical patient. ©2012 National Association of Social Workers. All Rights Reserved. ‹#›

6. INSTRUCTIONS - Step 3 Identify a Code From Reference Service List Select a code from the Reference Service List that is most similar in time and work to the new/revised CPT code descriptor and typical patient described. ©2012 National Association of Social Workers. All Rights Reserved. ‹#›

7. INSTRUCTIONS - Step 4 Estimation of Time Based on your personal experience, estimate how much time it takes you to perform the psychotherapy service using the vignette and the description of services of the new/revised CPT code. ©2012 National Association of Social Workers. All Rights Reserved. ‹#›

8. Explanation of Pre-service Period The pre-service period includes services provided before the service and may include preparing to see the patient, reviewing records, and communicating with other professionals. ©2012 National Association of Social Workers. All Rights Reserved. ‹#›

9. Explanation of Intra-service Period Intra-service period includes the services provided during the face-to-face psychotherapy with the patient and/or family. ©2012 National Association of Social Workers. All Rights Reserved. ‹#›

10. Explanation of Post-service Period The post-service period includes services provided after the service and may include arranging for further services, reviewing results of studies, and communicating further with the patient, family, telephone calls, referrals and documentation of services. ©2012 National Association of Social Workers. All Rights Reserved. ‹#›

11. INSTRUCTIONS - Step 5 Compare the Psychotherapy Code to Reference Service Code Compare the complexity and intensity of the code being surveyed with the selected reference service code. Identify each of the components of both services. Focus only on the work that you perform during each of the identified components. ©2012 National Association of Social Workers. All Rights Reserved. ‹#›

12. Definitions Work includes the following elements: Time it takes to perform the service. Mental effort and judgment necessary with respect to the amount of clinical data that needs to be considered, the knowledge required, the range of possible decisions, the number of factors considered in making a decision, and the degree of complexity of the interaction of these factors. ©2012 National Association of Social Workers. All Rights Reserved. ‹#›

13. Definitions Continued Technical skill required with respect to knowledge, training and actual experience necessary to perform the service Physical effort can be compared by dividing services into tasks and making direct comparisons of tasks. When making the comparison, show that the differences in physical effort are not reflected accurately by differences in the time involved; if they are, considerations of physical effort amount to double counting of the work in the service. ©2012 National Association of Social Workers. All Rights Reserved. ‹#›

14. Definition Continued There are two kinds of psychological stress associated with work: (1) The pressure involved when the outcome is heavily dependent upon skill and judgment and an adverse outcome has serious consequences. (2) The second is related to unpleasant conditions connected with the work that are affected by skill or judgment. ©2012 National Association of Social Workers. All Rights Reserved. ‹#›

15. Definitions Continued These circumstances include situations with high rates of mortality or morbidity regardless of the clinician's skill or judgment, difficult patients or families, or physician physical discomfort. Of the two forms of stress, only the former is accepted as an aspect of work; the latter is considered to be a highly variable function of the clinician's personality. ©2012 National Association of Social Workers. All Rights Reserved. ‹#›

16. Definitions Continued Work does not include services provided by support staff employed by your practice who cannot bill separately including: Receptionists Technicians Secretaries Billers ©2012 National Association of Social Workers. All Rights Reserved. ‹#›

17. INSTRUCTIONS - Step 6 Estimate Work RVU (Relative Value Unit) The final step requests you to estimate the relative value unit. Consider the value assigned to the reference procedure in developing your estimate. The survey methodology attempts to set the work RVU of the psychotherapy code relative to the work RVU of the comparable and established reference code. ©2012 National Association of Social Workers. All Rights Reserved. ‹#›

18. INSTRUCTIONS - Step 6 Estimate Work RVU (Relative Value Unit) Based on your review of all previous questions, provide your estimate work RVU to the hundredth decimal point. Questions regarding the survey may be directed to mcoleman@naswdc.orgmcoleman@naswdc.org ©2012 National Association of Social Workers. All Rights Reserved. ‹#›