One of the country's most influential voices in the establishment of coding values now has a physical therapist at the helm: APTA member Richard Rausch, PT, DPT, MBA, has been elected as the co-chair of the American Medical Association's Specialty Society Relative Value Scale Update Committee Health Care Professionals Advisory Committee Review Board, or HCPAC. It's the first time in RUC history that a PT has held the position.
The committee reports to the AMA RUC panel, the group that makes annual recommendations regarding new and revised CPT codes related to health services, as well as potentially misvalued services, to the Centers for Medicare and Medicaid Services, which then determines Medicare provider payment. HCPAC — the group Rausch will co-chair — is charged with developing recommendations on values for the non-doctors of medicine or osteopathy-related CPT codes, which are then discussed by the overarching RUC panel. Recommendations from the RUC historically have figured heavily into payment decisions made by CMS.
Rausch has been involved with HCPAC for 10 years, first serving as the APTA alternate advisor 2010-2014 and then as the APTA advisor from 2015 to present. As the elected HCPAC co-chair, Rausch will preside over the three HCPAC meetings each year and represent the committee on the AMA RUC panel. Rausch was in private practice for over 30 years and now teaches health policy and business in the physical therapy program at the University of Illinois in Chicago.
Carmen Elliott, MS, APTA's vice president of payment and practice management, said that the nomination of a physical therapist in this role is big news.
"Although the primary role of the HCPAC co-chair is to represent all non-MD/DO professionals who are required to use CPT codes, the physical therapy profession will be better represented in this vital resource-based relative value system going forward,” Elliott said. “This is important in terms of patient and provider care and safety, especially during this time of a pandemic and into the future of value-based payment."
For additional insights into the RUC process and its relationship to payment, visit APTA's coding and billing page. You'll find links to podcasts, courses, issues and interpretations, and more.
