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Reimbursement Compression

Reading Time - 2 min


Why you should spend 2 minutes reading this:

Every 3-5 years, you'll experience a 10% decrease in inflation-adjusted reimbursement




The CMS updates the rates the government will pay you for medicare patients up to 4 times per year. 


If you haven't, read our introduction on Relative Value Units.


These rate updates indirectly impact all your contracts since most insurances will either:

  1. Peg their contracts directly to these rates

  2. Create an internal rate sheets based on CMS rates


Rates adjusted for inflation have traditionally decreased as the government aims to slow the increase of healthcare costs.


In some cases, the overall reimbursement stays the same but the RVUs shift from physician to practice and vice versa. Here are examples of the impact to different CPTs.

If you'd like to understand how rates have changed for a specific CPT since 2003, let us know below and we'll send you a model that contains all the necessary data.


If you'd like a full analysis on your practice and how it's been impacted, we can help as well. 


High-level actions you can take based on this article:

1. Understand how you have been impacted by rate changes

2. Understand how you may be impacted by rate changes

3. Develop a plan to avoid a 30% loss to your reimbursement in the next 15 years 

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