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Set the national fee schedule

Months 3–15; annual updates thereafter · Payment Rates Board; UHADiscuss this step
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Task 1.7.1 of 6

Start from the CY Medicare Physician Fee Schedule (about 10,000 codes) and apply specialty-group multipliers.

Who does it
Rates Board
When
Month 3–9
Trade-off

Using Medicare's RBRVS as the base is fast but inherits its known distortions favoring procedures.

Part of: Set the national fee schedule

Adopt Medicare's RBRVS fee schedule as the base, raise primary care to 125% of Medicare, procedural specialties to 105%, and others to 112% on average. Physician & clinical UHP spending becomes $1.05T (price effect −$21.4B, utilization effect +$113.0B).

This step changes 6 existing laws, programs, or institutions. See the list.