As part of CMS’ quarterly update for 3rd Quarter 2020, the Agency announced retroactive changes to the Professional Liability Insurance (PLI) Relative Values (RVUs) for dozens of procedures paid under the Medicare Physician Fee Schedule. The PLI RVUs are one of the three components, the other two being “work” and “practice expense” of the Medicare Total RVU for Physician payments for Medicare services.  The adjustments are positive for spine surgical procedures, varying from .50 RVUs to 1.50 RVUs.

The updated payments will be automatically updated by Medicare for all Medicare claims made from July 1, 2019 through December 31, 2019, but was also made retroactive to January 1, 2019. Providers who billed Medicare for any of the CPT codes listed below since January 1, 2019 can seek retrospective payments through the local Medicare Administrative Contractor (MAC).

The following codes are relevant for ISASS members.

Read the CMS Manual System Update: CMS Quarterly Update 7-1-19 MPRVU Correction 5-3-19

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