Robert M. Centor, MD; Larry Culpepper, MD, MPH; Robert W. Morrow, MD; Roy M. Poses, MD


March 05, 2013

In This Article


The American Medical Association (AMA)/Specialty Society Relative Value Scale Update Committee (known as the RUC) has been a source of great contention, particularly among primary care physicians. It was founded to provide an expert panel that would develop relative values for new or revised Current Procedural Terminology (CPT) codes and make recommendations to the Centers for Medicare & Medicaid Services (CMS). Many experts have complained that primary care is underrepresented on this committee, so that the fees evolving from these recommendations favor the specialist.

In his Medscape blog, Brian Klepper discussed a recent rejection by a federal appeals court of a challenge to the RUC by 6 Georgia primary care physicians. Klepper wrote, "The core of the Augusta physicians' legal challenge was that the RUC is a 'de facto Federal Advisory Committee,' and therefore subject to the stringent accountability requirements of the Federal Advisory Committee Act (FACA). This law ensures that federal bodies have panel compositions that are numerically representative of their constituencies, that their proceedings are open, and that methodologies are scientifically credible."

Medscape sought responses from its primary care roundtable on the validity of the RUC and whether there's a solution to the ever-challenging issue of how primary care physicians should be paid.