Specialty Society Relative Value Scale Update Committee

The Specialty Society Relative Value Scale Update Committee or Relative Value Update Committee (RUC, pronounced "ruck") is a volunteer group of the American Medical Association that makes recommendations on the relative value of types of procedure done by physicians. These recommendations, if accepted by the U.S. Centers for Medicare & Medicaid Services, are used to compute health care prices in the United States' public health insurance program Medicare.

Background

Before the 1992 implementation of the Medicare fee schedule, physician payments were made under the "usual, customary and reasonable" payment model (a "charge-based" payment system). Physician services were largely considered to be misvalued under this system, with evaluation and management services being undervalued and procedures overvalued. Third-party payers (public and private health insurance) advocated an improved model to replace the UCR fees, which had been associated with stark examples of specialists making significantly higher sums of money than primary care physicians.

With reference to the research of William Hsiao and colleagues, the Omnibus Budget Reconciliation Act of 1989 was passed with the legislative intent of reducing the payment disparity between primary care and other specialties through use of the resource-based relative value scale (RBRVS). Beginning in 2000, all three components of the Medicare RBRVS, physician work, practice expense and malpractice expense are resource-based as required by Section 1848(c) of the Social Security Act.

Workings

RUC was established in 1991 by the American Medical Association (AMA) and medical specialist groups. The AMA sponsors RUC "both as an exercise of 'its First Amendment rights to petition the Federal Government' and for 'monitoring economic trends ... related to the CPT [Current Procedures and Terminology] development process".