HRS Continues Active Participation in AMA RUC Activities | Heart Rhythm Society

HRS Continues Active Participation in AMA RUC Activities

The American Medical Association (AMA)/Specialty Society Relative Value Scale Update Committee (RUC) has been a key stakeholder in maintaining and updating the relative value units (RVUs) of physician services and making recommendations to the Centers for Medicare & Medicaid Services (CMS) that directly affect physician payment since the implementation of the resource-based relative value scale (RBRVS) system in 1992.


Given the important role that the RUC plays in convening clinical experts to make these assessments and recommendations on RVUs, the Heart Rhythm Society, through its membership in the AMA House of Delegates, has long been engaged to bring the unique expertise of electrophysiology that only HRS can provide to the RUC's deliberations. While these RVU recommendations are considered by CMS for Medicare physician payment, the final RVU assignments made to CPT codes have far-reaching implications for reimbursement beyond Medicare payments.

There are two separate, but equally important, RUC roles (Representative and Advisor). The RUC is primarily constituted of representatives from across the spectrum of specialties, and while one voting representative seat on the committee is dedicated to a physician representing cardiology, the RUC also includes specialists representing a long list of other specialties: anesthesiology, cardiothoracic surgery, dermatology, emergency medicine, family medicine, general surgery, geriatrics, hospital medicine, neurology, neurosurgery, obstetrics and gynecology, ophthalmology, orthopaedic surgery, osteopathic medicine, otolaryngology, pathology, pediatrics, physical medicine and rehabilitation, physical therapy, plastic surgery, psychiatry, radiology, and urology. There are also several "rotating seats," which are currently held by physicians in the specialties of internal medicine, pulmonary medicine, and vascular surgery. While RUC Representatives are allowed to vote on RVU recommendations, they are not allowed to advocate on behalf of their respective medical specialty.

In addition to the role of voting RUC Representatives, the societies affiliated with the AMA house of Delegates, including HRS, provide expertise via "RUC Advisors" who put forth and defend RVU recommendations. HRS RUC Advisors are critical to providing the clinical expertise needed for the RUC Representatives on the committee to evaluate RVUs for electrophysiology services. A significant amount of time and dedication is provided by HRS' primary RUC Advisor, Dr. Mark Schoenfeld, and the HRS alternate RUC Advisor, Dr. David Slotwiner.

Dr. Schoenfeld is a Past President of the Heart Rhythm Society, and currently is a Professor of Cardiology, Clinical Medicine at the Yale University School of Medicine. Dr. David Slotwiner is the Chief of Cardiology at New York-Presbyterian Queens. Both are longstanding members of the Society's Health Policy and Regulatory Affairs Committee and have worked with various federal agencies, including CMS on reimbursement and coverage policies and with the FDA on drug and device approval and research protocols.

The valuation of codes by the RUC is an iterative process that continues to demand more time of those involved. Without the participation of HRS and its Advisors, the ability of the RUC to understand and evaluate electrophysiology services would be severely diminished, and RVU recommendations would be voted on without the voice and expertise of electrophysiologists. We understand that there has been some confusion about the status of HRS' ability to provide this input, but HRS has participated in this advisory capacity since the Society became a member of the AMA House of Delegates 15 years ago and continues to do so. Our ability to provide this expertise in the RUC forum is dependent on HRS' continued membership in the AMA House of Delegates.

We understand that the process can seem complicated and never-ending, so we encourage HRS members with questions about the RUC to contact our advisors, Dr. Schoenfeld and Dr. Slotwiner, or HRS health policy staff, Lisa Miller, with any questions.

Membership Reminder