What to Do When the Medicare Fee Schedule Changes

Every year the Medicare Physician Fee Schedule is updated, and every year the coverage is about the headline conversion factor. For most practices that number is the least useful part of the announcement.

What actually determines your revenue is which of the codes you bill most often had their relative value units changed, and whether any of them moved enough to change how you schedule or staff. A specialty that bills a narrow set of codes can see a materially different outcome from the headline percentage — in either direction.

The practical exercise is short. Pull your top twenty codes by volume and your top twenty by dollars — they are rarely the same list. Check the new RVUs against last year's for each. Multiply the difference by your actual annual volume. That gives you a real number for your practice rather than an industry average.

Then check the quieter changes: new codes that let you bill for work you already do, codes that have been bundled into others, and any change to global periods. Those tend to matter more than the conversion factor and get a fraction of the attention.