Grimaldi Paul L
State Healthcare Division of Affiliated Computer Services, Inc., Rockville, MD, USA.
J Health Care Finance. 2002 Spring;28(3):88-104.
Beginning January 1, 1992, Medicare has relied on a resource-based relative value scale (RBRVS) to establish physician fees. Medicare pays 80 percent of the lower of the amount a physician bills for the service or the fee schedule amount. The patient is responsible for the remaining 20 percent, as well as the annual Part B deductible of $100, plus any additional amount the physician may be allowed to bill. Rarely is the billed amount below Medicare's fee schedule amount. Adoption of the RBRVS fee schedule severed the link between the amount a physician charged for a service and the amount Medicare paid for it. RBRVS implementation required significant changes in the coding system used to document and bill physician services, particularly medical visits and consultations.
自1992年1月1日起，医疗保险（Medicare）一直依靠基于资源的相对价值尺度（RBRVS）来确定医生费用。医疗保险支付医生为该服务开具账单金额或费用表金额中较低者的80%。患者负责其余的20%，以及每年100美元的B部分免赔额，加上医生可能被允许额外开具账单的任何金额。开具的账单金额很少低于医疗保险的费用表金额。采用RBRVS费用表切断了医生为一项服务收取的费用与医疗保险为此支付的金额之间的联系。实施RBRVS需要对用于记录和开具医生服务账单的编码系统进行重大更改，特别是医疗就诊和会诊。
