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Doctor, are you looking for the savvy and skills to accelerate practice profits, productivity, and personal influence (Docgitimacy™) so you have the time to enjoy a vibrant life with those you love?

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Disclaimer: The information in these show episodes (and the accompanying descriptions, show notes, and links) is provided for informational purposes only. The information is a result of years of practice experience by the author and show guests. This information is not intended as a substitute for the advice provided by your physician, attorney, accountant or other professional. Do not disregard professional advice or delay in seeking professional advice because of something you have seen, heard or read related to this show. Information in this show (and the accompanying descriptions, show notes, and links) and the use of any products or services trialed or purchased by you DOES NOT create a doctor-patient relationship, an attorney-client relationship or any other professional-client relationship between you and any of the providers affiliated with this show. Information and statements regarding health regimens, drugs and/or dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease. or any information contained on or in any product label or packaging. Always speak with your physician or another healthcare professional before taking any medication or nutritional, herbal or homeopathic supplement, or using any treatment for a health problem. If you have or suspect you have a medical, legal and/or accounting problem, contact your health care provider, attorney and/or accounting provider promptly. 

  1. All Episodes
  2. The Hidden System That Determines What Doctors Get Paid

The Hidden System That Determines What Doctors Get Paid

May 31, 2025

Ever wonder where those five-digit codes on your medical bills come from and who decides what they're worth? In this episode, Dr. Lori Barr breaks down the two systems that form the backbone of physician reimbursement in the United States: Relative Value Units (RVUs) and CPT codes.

In This Episode, You'll Learn:

  • What medicine looked like before RVUs and why the old "fee for service" model was like getting a haircut in different cities
  • How Harvard economist Dr. William Hsiao developed the RVU system in the 1980s to bring transparency and fairness to physician payments
  • The three components of every RVU: physician work, practice expense, and malpractice
  • How the 1989 Omnibus Budget Reconciliation Act and 1992 Medicare adoption of the RBRVS transformed how healthcare services are valued
  • The role of CMS (Centers for Medicare & Medicaid Services) as the final authority on the physician fee schedule
  • What CPT codes are and how the AMA develops and maintains them
  • The powerful RUC (Relative Value Scale Update Committee) and the fact that CMS follows its recommendations 75-90% of the time
  • Which medical specialties currently have seats on the CPT Editorial Panel and the RUC Committee (as of May 2025)
  • Three actionable ways to get your voice heard: join your specialty societies, volunteer for committees, and write to committee members with a warm introduction