Question
Can you explain billable time units (BTU) and how they are calculated? Our hospital is moving toward BTU use, but I understand these are not available for audiology at this time.
Answer
Billable time units (BTUs) are work relative value units (RVUs), and this is being imposed in many places. RVUs represent billable income, and are you maintaining the work effort. The work RVU is going to be the key because that is where the primary reimbursement is. If you use CPT code 92557 (comprehensive audiometry), for example, the work RVU is .6, and that would give you credit for generating .6 RVUs. If you do visual reinforcement audiometry (VRA), that RVU value is .7, so that would go into the bank and get credit for .7 generation. The same holds true for tympanometry and all the rest.
Where it gets a little sticky for us when it comes to our codes is that we are still in practice expense with either no work RVU or very small proxy work RVU for the majority of our codes. So if you do pure-tone air conduction only, which we would have to get credit for practice expense RVU, and some systems have difficulty adapting to that, but that is really what would be necessary for us to remain equitable to the rest of the system in terms of accounting for our work productivity. Typically, BTU refers only to the work RVU and nothing more. That's your actual work that you generate, that represents what you're billing, and what they can anticipate as income.
Editor’s Note: This Ask the Expert was taken from the eSeminar Reimbursement: The 2012 Perspective published on 2/9/2012. To access the recorded course, please go here.
