Medicare Physician Fee Schedule Overview
Instructor
Description
Get a clear, coder-focused introduction to the Medicare Physician Fee Schedule (MPFS) with Medicare Physician Fee Schedule Overview, a self-paced, online course designed for those working in professional fee (profee) coding. Whether you’re new to MPFS or want to strengthen your understanding of how RVUs, geographic adjustments, and conversion factors affect reimbursement, this course breaks it down in practical, relatable terms. You’ll learn how to interpret the Relative Value File and avoid common coding errors that can lead to under- or overpayments. This course includes one AHIMA CEU and is a great fit for coders looking to build confidence with physician payment methodology.
Included Lessons:
- What is the Medicare Physician Fee Schedule?
- Calculating Fees for the Medicare Physician Fee Schedule
- How are RVUs and Medical Coding Related?
- Using the Medicare Physician Fee Schedule's Relative Value File
- Columns A, C-E - Payment Eligibility
- Columns B and N - Professional and Technical Components
- Columns F-M, Y - RVU Calculations
- Columns O-R - Global Packaging
- Columns S-W - Application of Modifiers that Impact Pricing
- Columns X, Z and AB-AE - Miscellaneous
- Medicare Physician Fee Schedule - Look-up Tool
CEUs available for the following credentials:
AHIMA
CCA, CCS, CCS-P, RHIT, RHIA, CDIP, CHDA, CHPS
Key Takeaways
- MPFS Fundamentals: Understand what the Medicare Physician Fee Schedule (MPFS) is and how it impacts physician reimbursement for Medicare services.
- RVUs and Payment Calculation: Learn how Relative Value Units (RVUs), the Geographic Practice Cost Index (GPCI), and the Conversion Factor are used to calculate payment rates.
- RBRVS and Its Components: Grasp the components of the Resource Based Relative Value Scale (RBRVS), including work, practice expense, and malpractice RVUs.
- Coding Impact on Reimbursement: Recognize how coding accuracy affects RVU assignment, provider payment, and compliance.
- Common Pitfalls: Identify and avoid coding errors such as unbundling, undercoding, and overcoding that can distort RVU-based payments.
- Using the Relative Value File: Gain hands-on experience interpreting the Relative Value File and understanding its structure and data points.
- Modifier and Status Indicators: Learn how modifiers and Medicare status indicators affect billing, payment eligibility, and global surgical package application.
Benefits of Taking this Course
- Improved Understanding of Physician Payment
- Stronger Grasp of RVU-Based Reimbursement
- Better Awareness of Coding's Financial Impact
- Greater Confidence with Medicare Fee Calculations
- Enhanced Accuracy with Modifiers and Status Indicators
- Hands-On Familiarity with the Relative Value File
FAQs
What is the Medicare Physician Fee Schedule, and why should coders understand it?
The Medicare Physician Fee Schedule (MPFS) is how Medicare reimburses physicians and other providers for covered services. As a medical coder, understanding the MPFS helps you see how CPT codes translate into payment, especially through RVUs. It’s essential for accurate coding, avoiding denials, and ensuring providers are paid correctly.
What will I learn about RVUs in this course?
You’ll learn what RVUs are, how they’re calculated, and how they impact Medicare payments. The course breaks down work, practice expense, and malpractice RVUs, and shows you how to apply them using the Relative Value File.
About Our Medical Coding Courses
HIAlearn, powered by Health Information Associates (HIA)—a leader in medical coding and auditing for more than three decades—offers a flexible, online education platform designed for today’s coders. With a growing catalog of AHIMA and AAPC-approved coding courses, HIAlearn supports both beginners and experienced coders looking to build confidence, accuracy, and CEU credits.
Courses are available across various coding types including CPT, E/M, ICD-10-CM, and ICD-10-PCS, and are designed for multiple specialties including inpatient, outpatient, profee, and CDI.
To stay up to date, coders can explore our Coding Updates hub for the latest ICD-10-CM, ICD-10-PCS, CPT, and IPPS changes. HIAlearn also supports organizations with group discounts and scalable team access, promoting accuracy, compliance, and continuous professional development across departments.
Overview
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