2026 Audit-Proof Pricing Strategies to Protect Revenue

Course Description

Every insurance payor uses RBRVS to determine their fee schedules, whether you know it or not. Even though “RVUs” are a Medicare construct, they still have tremendous impact on pediatricians. How can you leverage RBRVS to set your prices fairly, accurately, and easily.

In this course, we will briefly review the history of RBRVS to give us a background of its original intent. We will then dig into the individual elements of each RVU - practice expense, physician work, and professional liability – and how they combine with the Geographic Practice Cost Index to create an RVU value for every CPT code. Finally, we’ll convert each CPT’s RVU value to an actual price, including a Medicare multiplier, so you have a clear and defendable pricing model.

If that sounds boring and academic, fear not. You’ll also be given directions to a free tool to help calculate your RVUs, pricing, and complete all kinds of easy analysis.

Learning Outcomes:

• Learn how every payor uses RBRVS to set their prices.
• Understand why RBRVS is vital since 2021.
• Learn how to update your prices.
• Learn how to use RVUs to measure productivity.
• Discuss how to price non-RVU procedures (labs, vaccines).
• Understand each of the 3 elements that make up an RVU.
• Understand how the Fed’s GPCI adjustment affects you.

Areas Covered in the Session:

• Not having a formal pricing system will lead to lost revenue
• There is a formal method that payors and health systems use to set pricing and measure productivity.
• Even though RBRVS is Medicare driven, it still has significant impact on pediatricians.
• Big changes happened in 2021 that pediatricians need to consider.
• Every practice has holes in its pricing, this is the fastest way to find them.
• Learn how to use a free tool to calculate your RVUs, pricing, and payments.
• Compare yourself to other practices.
• Live Q&A Session

Recommended participants:

• Independent Pediatric Practices
• Independent Primary Care Practices
• Physicians Who Want to Measure their Own Productivity
• Billing Departments, External Billing Services
• Practice Administrators and Office Managers
• Revenue Cycle Management Teams
• Pediatric Nurse Practitioners and Physician Assistants Involved in Coding and Billing
• Compliance Officers and Financial Managers in Healthcare Practices
• Consultants Who Advise Medical Practices on Operations and Pricing
• Medical Group Executives and Decision-Makers Evaluating Fee Schedules
• Health IT Staff Supporting Billing and Reporting Tools
• Medical Students, Residents, and Fellows Interested in Practice Management Basics

About the Presenter

Chip Hart is the Director of PCC's Pediatric Solutions team and author of the popular blog Confessions of a Pediatric Practice Consultant (pedsource .com/ chipsblog). Chip's three decades of pediatric practice management expertise has helped hundreds of pediatricians increase their financial and financial health.

As a dynamic and motivating speaker, Chip leads educational seminars and consults for pediatric professionals nationwide for organizations such as the AAP, state chapter AAP programs, Pediatric Management Institute, Pediatric CEO, and various physican and hospital organizations around the country. You are most likely to recognize him from the Pediatric COVID webinars he did with Paul Vanchiere.rt.