When Is Your Work Not Really “Work”? Any speech-language pathologist (SLP) who bills for their services is familiar with CPT (Current Procedural Terminology) codes. Each procedure billed must be linked to a specific code or codes. These 5-digit codes are a universal language understood by all payers. That is, whether you bill an evaluation with the code ... Article
Article  |   July 01, 2005
When Is Your Work Not Really “Work”?
Author Affiliations & Notes
  • Nancy B. Swigert
    ASHA Health Care Economics Committee
Article Information
Special Populations / Genetic & Congenital Disorders / Practice Management / Regulatory, Legislative & Advocacy / Articles
Article   |   July 01, 2005
When Is Your Work Not Really “Work”?
SIG 5 Perspectives on Speech Science and Orofacial Disorders, July 2005, Vol. 15, 14. doi:10.1044/ssod15.1.14
SIG 5 Perspectives on Speech Science and Orofacial Disorders, July 2005, Vol. 15, 14. doi:10.1044/ssod15.1.14
Any speech-language pathologist (SLP) who bills for their services is familiar with CPT (Current Procedural Terminology) codes. Each procedure billed must be linked to a specific code or codes. These 5-digit codes are a universal language understood by all payers. That is, whether you bill an evaluation with the code 92506 in Iowa or or in Kentucky, the payer understands that this was the same procedure.
The way the codes are valued leads directly to how the procedure will be reimbursed by Medicare (and many other payers follow that Medicare model). The American Medical Association (AMA) has a committee called the Relative Value Update Committee (RUC). For all new codes, and periodically for existing codes, the RUC analyzes several factors that are in the formula that determines a relative value (that is, compared to other codes is a particular code more difficult, does it require more costly equipment, is more support staff needed?). The largest part of that formula is “physician work.” Some of the codes that SLPs use have a value in the column called “physician work.” Neither the AMA nor the Centers for Medicaid and Medicare Services (CMS) can remember how or why that happened. Of course, we are aware that the performance of those procedures involves no work by the physician: the work is that performed by the SLP.
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