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CMS Data Helps Analyze Hospitalist Billing Outliers

  • June 18 2014, 11:33am EDT
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Medicare physician payment data shows that more than 1,000 primary care physicians providing hospital-based services billed Medicare more than five times the average, raising questions about their billing practices, according to a new analysis from Phoenix-based Innovative Solutions Consulting.

The data reveals that the top 1,000 primary care physicians providing hospital-based services averaged more than 9,300 work relative value units (wRVUs) or 7.5 timesthe average for all primary care physicians and 5.3 times the average hospitalist. The top 263 physicians each billed more than 10,000 wRVUs, with one hospitalist topping out at more than 40,000 wRVUs.

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