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Relative Value Units (RVUs) are a measure of value used by the CMS as part of a reimbursement formula for physician services. The Desktop Charge Capture application allows organizations to modify the starting RVU values for individual charge codes, and configure ranges of charge codes to sort in descending order based on RVU value. For the charges within the defined ranges, you can also optionally apply RVU multipliers to increase or decrease the RVU value, and/or automatically add a modifier. In addition, individual users can view the RVU values for charge codes on the Charge Transaction screen and in the Charges > Holding Bin option. And finally, users can view summarized RVU information for themselves or their department(s) in both table and graph formats, on the Charges > RVU tab. Before you can use any of the features described above, your Commure Pro representative must load a data file of starting RVU values for each CPT code (and optionally each modifier). Once the data file is loaded:
  • Administrators can use the Manage RVU Values and Auto-Sorting options modify RVU information and determine the sort order, RVU multipliers, and an auto-added modifier for ranges of charge codes.
  • All charges entered from that point forward will store RVU data for reporting on the Charges > RVU tab. This is an optional report that can be enabled per user via the following setting:Set RVU Report Access.
  • When entering charges, RVU data can be viewed directly on the Charge Transaction screen and in the Charges > Holding Bin option. This is an optional feature that can be enabled per user via the following setting:Show RVU Values to User. This chapter reviews how to configure the RVU Management feature. For instructions the daily usage of the Charges > RVU tab, please refer to RVU (Classic).

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Availability of the RVU Management Feature on Web versus Handheld Platforms

Once the RVU feature is configured, charge transactions entered on any platform (web, Apple, or Android) will have RVU data saved if they contain charge codes with associated RVU values. However, the ability to view and report on RVU data is available on only the web platform.

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Using RVU Management with Other Charge Capture Features

The RVU Management feature can be used in conjunction with the following features:
  • Automated Code Entry. If a user enters a master code that also has an RVU associated with it, and then submits the transaction, the appropriate auto-added charges, modifiers, and/or diagnoses are automatically added to the charge transaction. In addition, the charges are saved with the RVU values, and if appropriate, the charge codes are auto-sorted based on RVU, the RVU values are multiplied, and a modifier is added. See Configuring Automated Code Entry.
  • Batch Charge Entry. If a user enters one or more charge codes on the Batch Charge Entry screen that have RVU values associated with them, and then submits those charges for multiple patients, the charges are saved with the appropriate RVU values. In addition, if appropriate, the charge codes are auto-sorted based on RVU, the RVU values are multiplied, and a modifier is added. See Configuring Batch Charge Entry.
  • Charge Data Master (CDM). This feature can be used in conjunction with RVU Management. Both features work in tandem and do not interfere/conflict in any way. See Implementing a Charge Data Master (CDM).
  • Custom Charge Capture Workflows. If a Custom Charge Capture Workflow screen automatically generates a charge code that has an RVU associated with it, then that charge code, once it is added to the Selected Codes section on the Charge Transaction screen, will show the RVU (if the user is configured to view it), and that RVU is saved with the charge code on the transaction. In addition, if appropriate, the charge codes are auto-sorted based on RVU, the RVU values are multiplied, and a modifier is added. See Configuring Custom Charge Capture Screens.
  • Hold for Review. The Hold for Review feature can be used in conjunction with the RVU Management feature. Upon submitting a charge transaction that is held for review, the charges are saved with the appropriate RVU values (including auto-sorting those codes, possibly multiplying the RVU values, and possibly adding modifiers after saving the transaction). See Configuring the Hold for Review Workflow.
  • PQRS. The association of an RVU with a charge code (including auto-sorting those codes, possibly multiplying the RVU values, and possibly adding modifiers after saving the transaction) does not interfere with the PQRS process in any way. Once the transaction is submitted, it is evaluated to see if it meets the quality reporting criteria, and if so, the appropriate quality measure questions are presented to the provider. See Configuring PQRS/MIPS.
  • Selection of NDC Codes. This feature can be used in conjunction with RVU Management. Both features work in tandem and do not interfere/conflict in any way. See Configuring the Selection of NDC Codes During Charge Capture.

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Steps for Configuring RVU Management

The steps for configuring RVU Management are listed in the table below.
StepWhere Documented
1. A Commure Pro representative must load a data file of starting RVU values, and optionally update previously entered charges with RVU data.Loading the RVU Data File
2. (Optional) An administrator can change the numeric RVU for one or more charge codes.Modifying RVUs for Specific Charge Codes
3. (Optional) An administrator can configure additional options for sorting ranges of charge codes on charge transactions based on RVU and financial class, using RVU multipliers, or automatically adding a modifier to the charge transaction.Configuring Additional Options for Auto-Sorting and Modifiers
4. An administrator should configure user settings related to viewing RVU information.Configuring User Settings for RVU Management

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Loading the RVU Data File

Before you can use any of the features of RVU Management, a Commure Pro representative must load a data file of starting RVU values for each CPT code (and optionally each modifier). This process loads the charge codes and their associated RVU values into the Commure Pro database. You can use the standard data file that is created by CMS and that contains the RVU values that CMS uses when calculating reimbursement for each charge code, or you can provide an alternate file for Commure Pro to load if desired. In addition, your representative can run an update utility that will calculate RVU information for older historical charges that were entered prior to loading the RVU data file. The update utility applies the RVU value that is stored in the database to the historical charge transactions. Therefore, if you run the update utility immediately after loading the RVU data file, then the values from the data file (that were just loaded into the database) are used. If you load the RVU data file, then make modifications to some of the RVU values using the Manage RVU Values option, and then run the update utility, then the modified RVU values are used (see Modifying RVUs for Specific Charge Codes for information on modifying RVU values). Please note that the update utility does not do any auto-sorting, RVU multiplying, or auto-adding of modifiers that might be configured in the Auto-Sorting option (see Configuring Additional Options for Auto-Sorting and Modifiers for more information). If you want to implement RVU Management, contact your Commure Pro representative to load the RVU data file and optionally run the update utility.

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Modifying RVUs for Specific Charge Codes

You can change the numeric RVU value for a given charge code using the Manage RVU Values option. This option allows you to enter a different numeric RVU for a single charge code, or for a charge/modifier combination.

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Viewing the Current List of RVU Entries

To view the current list of RVU entries:
  1. Select Admin > Institution > Charge Capture > RVU Management > Manage RVU Values. The RVU screen is displayed with criteria fields for Year and CPT code listed at the top of the screen. All RVU entries for the current year are immediately shown by default, sorted by CPT code.
  2. (Optional) To view information for specific RVU entries, enter data in the criteria fields below and then click the Search button. Only RVU entries that meet all of the criteria you define are displayed.
    • Year: Select a year from the drop-down to see only those RVU entries defined for use in a specific year.
    • CPT: Enter one or more CPT codes to view only the RVU entries for those CPT codes. Enter a full or partial code or description, click the Search icon to find the code, and then select it to add it to the list. After clicking Search, all RVU entries that meet your criteria are displayed in a table format.
The column contents are described below. Any column heading that has arrows indicates that you can click it to sort the list by that item. Please note that each row represents an RVU entry that has a numeric value (even if that value is 0). An RVU entry can consist of a CPT code alone, or a combination of a CPT code and a Modifier code.
  • CPT: The CPT code for the RVU entry. This CPT code must already exist in the Nomenclature Vocabularies; you cannot add new CPT codes in this option.
  • Modifier: The Modifier code for the RVU entry. This Modifier code must already exist in the Nomenclature Vocabularies; you cannot add new Modifier codes in this option. This column may be blank if the CPT code has a relative value unit when it is used without a modifier.
  • RVU Work: The work relative value unit associated with the CPT alone, or associated with the CPT/Modifier combination.
  • Year: The year for this RVU entry.
  • Edit icon : Click the icon open the RVU Detail screen so that you can modify the RVU entry.
  • Delete icon : Click to delete the RVU entry for this CPT or CPT/Modifier combination.

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Adding a New RVU Entry

To add a new RVU entry, follow the steps below.
  1. Select Admin > Institution > Charge Capture > RVU Management > Manage RVU Values. The RVU screen is displayed.
  2. Use the criteria fields at the top of the screen to view some or all of the entries (see Viewing the Current List of RVU Entries for instructions). You should check to make sure that the entry you are about to add does not already exist.
  3. Select the Add RVU button. The RVU Detail screen is displayed.
  4. Complete the fields on the RVU Detail screen as follows:
    1. CPT (required): Select a CPT code from the CPT Nomenclature Vocabulary. You can enter the full numeric code if you know it, or search for one. To search, enter any portion of the code or description and then click the Search icon .
    2. Modifier: Select a Modifier code from the Modifier Nomenclature Vocabulary. You can enter the full numeric code if you know it, or search for one. Click the Search icon to view the full list of modifiers, or enter any portion of the code and then click the Search icon to search for a specific code. You can leave this field blank if the CPT code has a relative value unit when it is used without a modifier.
    3. RVU Work: Enter the numeric work relative value unit associated with the CPT alone, or associated with the CPT/Modifier combination. Enter a numeric value, including a decimal point if necessary. A value of 0 is allowed.
    4. Year: Select the year for this RVU entry.
  5. Click the Save button to save the new RVU entry.
  6. Repeat Step 3 through Step 5 to add more RVU entries.
  7. When you are done adding entries, click X at the top right of the RVU screen, and then click Save on the Charge Capture settings screen.

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Editing or Deleting a RVU Entry

To edit or delete a RVU entry, follow the steps below.
  1. Select Admin > Institution > Charge Capture > RVU Management > Manage RVU Values. The RVU screen is displayed.
  2. Use the criteria fields at the top of the screen to display the entries that you want to edit or delete (see Viewing the Current List of RVU Entries for instructions).
  3. Click one of the icons below for the row that you want to edit or delete:
    • Edit icon : Click to open the RVU Detail screen so that you can modify the RVU information, such as the CPT code, Modifier code, RVU Work, or Year. See Adding a New RVU Entry for a full description of each field. When you are done making changes, click the Save button.
    • Delete icon : Click to delete the RVU entry.
  4. Repeat Step 3 to edit or delete additional RVU entries.
  5. When you are done editing/deleting entries, click X at the top right of the RVU screen, and then click Save on the Charge Capture settings screen.

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Configuring Additional Options for Auto-Sorting and Modifiers

Use the Auto-Sorting option to configure specific ranges of charge codes to automatically sort in descending order based on RVU value after a charge transaction is saved. You can also specify whether the auto-sorting should occur only for charge transactions with certain financial classes, or for all charge transactions. In addition, RVU multipliers (based on the modifiers entered with a charge code) can be used to increase or decrease the RVU value of the charge codes within your defined auto-sorting range. You can even automatically add a modifier to some of the charge codes within the defined auto-sorting range. The final sort order of the charges within a given transaction takes into account the quantity associated with each charge code, as well as any configured RVU multipliers. For example, if a charge code has an initial RVU value of 5, and the user enters a quantity of 2, then the RVU value is doubled to 10. This new RVU value is immediately visible on the Charge Transaction screen. Additionally, if the user applies a modifier to that same charge code, and that modifier has a defined RVU multiplier of 150%, then the doubled RVU value of 10 is multiplied by 1.5, resulting in a final value of 15. The multiplied RVU value is not immediately visible on the Charge Transaction screen, as RVU multipliers are not applied until after the user submits the charge transaction. Once the user submits the transaction, the final RVU value (15 in our example) is used when determining the placement of the charge code in the overall sort order for the transaction. Only those codes that are within a configured range are auto-sorted (in descending order by final RVU value), and they are placed after all other codes on the charge transaction. To configure a range of codes for auto-sorting, including optional RVU multipliers and auto-added modifiers, follow the steps below:
  1. Select Admin > Institution > Charge Capture > RVU Management > Auto-Sorting. The Configure RVU Auto-Sorting for Procedure Codes screen is displayed. Any previously entered values are shown by default.
  2. In the Selected CPT Codes Ranges section, specify one or more ranges of codes that should be auto-sorted based on RVU value.
    1. Click Add Range to add a row with blank From and to fields to the list.
  3. In the From field, enter the first code in the range. Enter a full or partial CPT code, click the Search icon to find the code, and then select it to add it to the list.
Search icon2 3. In the to field, enter the last code in the range. 4. Repeat Step a through Step c for additional ranges as needed. 3. (Optional) In the Selected Financial Classes section, you can specify one or more financial classes. If you do so, auto-sorting will occur only when the charge transaction is associated with a visit that has one of the specified financial classes.
  1. In the Select Financial Class field, enter any portion of financial class name, click the Search icon, and then select the financial class from the search results.
Search icon2 2. Repeat Step a for additional financial classes as needed. 4. (Optional) In the Set RVU Multipliers for Modifiers Added to Charge section, you can specify RVU multipliers for specific modifiers. If you do so, then when a user enters a charge code (within the range listed in the Selected CPT Codes Ranges section), and also associates one of the specified modifiers with that charge code, then the RVU value for the charge code is multiplied by the percentage that you specify here. For example, if you configure modifier 21 to have a RVU multiplier of 25%, and a user enters a charge code within the range (that has a base RVU value of 5, for example) with modifier 21, then the RVU value will be multiplied by .25 (resulting in a RVU value of 1.25, in our example). If a charge code has more than one modifier, and each of them has a RVU multiplier (for example, modifier 21 with a RVU multiplier of 25%, and modifier 50 with a RVU multiplier of 150%), both RVU multipliers are applied (largest first, one after another). Please note that RVU multipliers are applied after the user clicks the Submit button on the Charge Transaction screen.
  1. In the Select Modifier field, enter a full or partial modifier code, click the Search icon to find the code, and then select it to add it to the list.
Search icon2 2. Enter a percentage in the associated % field. 3. Repeat Step a and Step b for additional modifiers as needed. 5. (Optional) In the Automatically Apply Modifier to Auto-Sorted Charges section, you can specify one modifier to be automatically added to some of the charges listed in the Selected CPT Codes Ranges section. If you do so, then after the charges within the defined range are auto-sorted according to RVU value, the modifier that you enter here is automatically added to the second and subsequent charges within the auto-sorted list. If there are any charges within a defined range to which you do not want to automatically add the modifier, you can list them in the Exempt CPT Codes field. Please note that although no modifiers are automatically added to the exempt codes, the exempt codes are still auto-sorted, and still have RVU multipliers applied to them.
  1. In the Modifier field, enter a full or partial modifier code, click the Search icon to find the code, and then select it to add it to the list. This modifier will be automatically added to certain charge codes as described above.
Search icon2 2. In the Exempt CPT Codes field, select one or more codes (listed in the Selected CPT Codes Ranges section) that should not have the above modifier added to it. Use either method below to select the exempt CPT codes:
  • Enter the CPT codes one by one: Enter a full or partial charge code into the text field, click the Search icon to find the code, and then select it to add it to the list. Repeat for additional charge codes as necessary. Search icon2
    • Enter the CPT codes in bulk: Click the Bulk Entry icon . When the Bulk Text dialog is displayed, enter several codes, using any combination of these techniques:
  • Enter a list of codes, separated by commas. For example: 99360,99363,99364
  • Or, if you have the list of codes in another document or spreadsheet, you can copy that list (as long as the codes use the format described in the bullet above), and paste it into the Bulk Text dialog box.
  1. Click Save at the bottom of the Configure RVU Auto-Sorting for Procedure Codes screen, and then Save again on the Charge Capture settings screen.

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Configuring User Settings for RVU Management

There are two user settings that apply to RVU Management. Both settings affect only the Desktop Charge Capture application. The first setting determines whether the user is able to view the numeric RVU values for charge codes on the Charge Transaction screen and also in the Charges > Holding Bin option. Admin - User - Charge Capture - Show RVU Values to User The next setting determines whether the user is allowed to view the Charges > RVU tab, which contains a summary of RVU information in both table and graph formats. The user can be granted no access, access to the RVU data for just their own charges, or access to RVU data for the charges in their department(s). See RVU (Classic) for documentation on using the RVU tab. Admin - User - Charge Capture - Set RVU Report Access