Advocacy

Advocacy

RUC and CPT Activities

AAPM&R recognizes that many members may not be familiar with how payers determine the amount they should reimburse for each service. As payment has declined in recent years, these seemingly arbitrary cuts cause frustration. Your Academy advocates for fair reimbursement by providing input to the American Medical Association’s (AMA) Relative Value Scale Update Committee (RUC), which is one of the key processes by which the Centers for Medicare & Medicaid Services (CMS) determines how to value services.

Current Activities

In February/March 2019, a random selection of AAPM&R members participated in a RUC survey focused on E/M reimbursement. For more information on the RUC survey process, please watch the following video: Understanding the RUC Survey Instrument.

Voting Seat on RUC

In January 2019, for the first time, PM&R earned a voting seat on the American Medical Association (AMA) Relative Value Scale Update Committee (RUC). The huge victory is owed to the outstanding efforts of Matthew Grierson, MD, FAAPMR, who was elected by majority vote, after being nominated by the Academy the previous year.

For years, PM&R was one of a very few ABMS-recognized specialties to not have a voting seat on the RUC. Until 2018, we did not meet a set of 5 eligibility criteria. Nonetheless, your Academy has remained active in the AMA RUC since its inception, representing the interests of physiatrists. The Academy supports our volunteer RUC Advisors, including Dr. Grierson, who has represented the Academy for the past several years, along with other members from the Academy’s Reimbursement and Policy Review Committee who participate in RUC and related CPT activities. Earning the RUC seat is a direct result of Dr. Grierson’s passion for the specialty, engagement in the AMA process, and keen understanding of the importance of the RUC in today’s reimbursement environment.

The RUC position is a 2-year rotating seat. It will provide other RUC members an opportunity to get to know PM&R and our representative. AAPM&R will support Dr. Grierson’s engagement on the RUC, and we will work collaboratively with him and the entire PM&R RUC delegation to earn a permanent seat on the RUC in the coming years.

Why the RUC Seat Matters

The RUC is one of the key processes by which the Centers for Medicare & Medicaid Services (CMS) determines how to value services. Its recommendations to CMS can be accepted, rejected or modified. These decisions have a ripple effect throughout the private insurance market and can affect compensation. Holding a RUC Seat will promote the visibility of PM&R in the House of Medicine and also gives our specialty a voice in deliberations about the valuation of codes presented to the RUC.