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The Omnibus Budget Reconciliation Act of 1989 enacted a Medicare fee schedule, and as of 2010 about 7,000 distinct physician services were listed. [2] The services are classified under a nomenclature based on the Current Procedural Terminology (CPT) to which the American Medical Association holds intellectual property rights. [ 2 ]
In 2015 CMS identified 254 quality measures for which providers may choose to submit data. The measures map to U.S. National Quality Standard (NQS) health care quality domains: [4]
The RBRVS for each CPT code is determined using three separate factors: physician work, practice expense, and malpractice expense. The average relative weights of these are: physician work (52%), practice expense (44%), malpractice expense (4%). [2] A method to determine the physician work value was the primary contribution made by the Hsiao study.
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[2] In 2013, the American Medical Association offered physicians training to understand the Sunshine Act. [3] A recent 2024 analysis suggests nearly 60% of experts who reviewed manuscripts for four major medical journals received at least one payment from the industry over a recent three-year period, with a total exceeding $1 billion. [4]
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