History of the RBRVS
December 1985
Initiation of Harvard National RBRVS Study.
September 1988
Harvard submitted Phase I of the RBRVS Final Report to the Health Care Financing Administration (HCFA).
December 1989
President George Bush signs the Omnibus Budget Reconciliation Act of 1989, enacting a physician payment schedule based on an RBRVS.
November 1991
Initial Meeting of the AMA/Specialty Society RVS Update Committee (RUC): RUC Charter documents were created; RUC approved for the formation of the Research Subcommittee, RUC Advisory Committee, and Health Care Professionals Advisory Committee.
January 1992
The Medicare RBRVS is implemented.
May 1992
RUC considers the first relative value recommendation from a specialty society. The American College of Obstetricians and Gynecologists presented a work RVU recommendation for CPT code 58345 Transcervical introduction of fallopian tube catheter... HCFA accepted this first RUC recommendation.
July 1992
The RUC submits its first set of recommendations to HCFA for 253 new and revised CPT 1993 codes.
May 1994
The RUC submits its 1,000th work relative value recommendation for a new or revised CPT code. The RUC also submitted more than 300 recommendations to HCFA for carrier-priced or non-covered services, including preventive medicine visits.
January 1997
Implementation of the first Five-Year Review of the RBRVS. The RUC had submitted recommendations for more than 1,000 CPT codes, including increases to the E/M services. HCFA accepted 95% of the RUC’s recommendations, which included RVU changes to 400 codes.
November 1998
RUC begins review of direct practice expense inputs. The Practice Expense Advisory Committee (PEAC) is created.
January 2000
Implementation of Resource-Based Professional Liability Insurance (PLI) relative values.
January 2002
Implementation of the second Five-Year Review of the RBRVS. The RUC submitted recommendations for 870 CPT codes, including changes to nearly 500 work RVUs in October 2000. Final implementation of Resource-Based Practice Expense Relative Values.
May 2003
The RUC submits recommendations from the PEAC on direct practice expense inputs. The PEAC has reviewed more than 3,500 codes, including all of the E/M codes.
March 2004
The PEAC has its final meeting. The PEAC has reviewed more than 6,500 codes.
January 2007
Implementation of the third Five-Year Review of the RBRVS. The RUC submitted recommendations for 751 CPT codes, including significant improvements to Evaluation and Management (E&M) services. CMS accepted 100 percent of the RUC's recommendations regarding E&M and 97 percent of the RUC's recommendations overall.
January 2009
CMS implements the first RUC recommendations resulting from efforts by the RUC's Five-Year Review Identification Workgroup to identify misvalued physician services. The CMS decision to implement all of the RUC recommendations results in a small increase to the 2009 Medicare Covnersion Factor.
