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Medicare Allowable and RVUs

Reading Time - 3 min

Why you should spend 3 minutes reading this:

RVUs can serve as the basis to run a data-driven provider group, failing to run a data-driven provider group can erode at your bottom line by 10-25%+



Relative Value Units (RVUs) are the primary units used by the Centers for Medicare and Medicaid Services (CMS) to determine reimbursement rates for medical services.


The system was created to bring standardization to charges within healthcare. Here's a quick review of how the CMS develops your reimbursement rates.

You can use these RVUs to determine:    

1. If you're reimbursing physicians correctly    

2. If you're running an operationally efficient practice and much more

In the end, you should aim to become a data-driven organization, more on that here.


The standardized reimbursement also serves as the building block to:
    1. Contract Management
    2. Location Management
    3. Physician Management

and overall practice management. You'll want to keep a close eye on rate updates as they could have a large impact on your practice/clinic as shown here. 


In order to utilize this powerful data, you will need to create analytic tools that latch onto your existing encounter data.


We have created tools to help you do that. Reach out in the form below to get started.


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

1. Understand how RVUs can empower you to become a data-driven provider

2. Transform yourself into a data-driven provider

3. Convert your functional groups into data-driven teams

4. Develop the best metrics for your provider group to protect your bottom line

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