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Related Experiment Videos

Evaluation and management services in the Resource-Based Relative Value Scale.

P Braun1, W C Hsiao, E R Becker

  • 1Department of Health Policy and Management, Harvard University School of Public Health, Boston, MA 02115.

JAMA
|October 28, 1988
PubMed
Summary
This summary is machine-generated.

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Physicians agree on the work involved in evaluation and management (E/M) services. However, billing code usage varies significantly by specialty, suggesting a need for revised coding systems.

Area of Science:

  • Medical Economics
  • Healthcare Policy
  • Clinical Practice Management

Background:

  • Evaluation and management (E/M) services are fundamental across all medical specialties.
  • Physicians generally agree on the work intensity of specific E/M services.

Purpose of the Study:

  • To investigate consistency in physician ratings of E/M service work.
  • To identify discrepancies in E/M billing code utilization across medical specialties.

Main Methods:

  • Utilized the magnitude-estimation method to survey physicians from various specialties.
  • Compared physician-assigned billing codes with expert-defined service work and time.

Main Results:

  • Work per unit of time for E/M services shows minimal variation across specialties and settings.

Related Experiment Videos

  • Significant differences were observed in how specialties apply E/M billing codes.
  • Intra-specialty variation in E/M code work was also substantial in some cases.

    • Conclusions:

    • Physician consensus exists on E/M service work, but billing practices reveal significant variability.
    • Potential solutions include developing specialty-specific relative value scales and redefining CPT codes with time specifications.