============================================================================= Run Date: MAR 26, 2025 Designation: FB*3.5*190 Package : FB - FEE BASIS Priority: Mandatory Version : 3.5 SEQ #164 Status: Released Compliance Date: APR 05, 2025 ============================================================================= Subject: UPDATE RBRVS FOR CY2025 Category: - Other Description: ============ ************************************************************************ NOTE: This patch is being released with a shortened compliance date of 10 days. ************************************************************************ Patch FB*3.5*190 updates the Resource Based Relative Value Scale (RBRVS) Fee Schedule with changes for Calendar Year (CY) 2025. EHRM Impact Statement: ----------------------------------- This patch can be installed at all sites, including EHRM converted sites. Patch Components: ----------------- Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- N/A Forms Associated: Form Name File Number New/Modified/Deleted --------- ----------- -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- N/A Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- N/A Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A Remote Procedures Associated: Remote Procedure Name New/Modified/Deleted --------------------- -------------------- N/A Parameter Definitions Associated: Parameter Name New/Modified/Deleted -------------- -------------------- N/A Additional Information: ----------------------- New Service Requests (NSRs): N/A Patient Safety Issues (PSIs): N/A Defect Tracking System Ticket(s) & Overview: -------------------------------------------- 1. INC37383864 The RBRVS Fee Schedule needs to be updated for the Calendar Year 2025 Problem: -------- The RBRVS Fee Schedule needs to be updated for the Calendar Year 2025. Resolution: ----------- This patch includes the data needed to calculate fee schedule amounts based on the RBRVS (also referred to as Medicare Physician Fee Schedule) for calendar year 2025. The RBRVS fee schedule for future calendar years will be issued by a patch as they become available. The RBRVS fee schedule data is contained in four existing files. These files are all stored in global "^FB". The following 4 files are included in the build of this patch, and will overwrite the current files upon install: FEE BASIS GEOGRAPHIC INDEX (#162.96) file FEE BASIS CPT RVU (#162.97) file FEE BASIS MODIFIER TABLE INDEX (#162.98) file FEE BASIS HCFA CONVERSION (#162.99) file The additional data added by this patch will increase the size of the FB global by approximately 8 MB. Installation of this patch will affect the menu options used to enter or edit payments for the Medical Fee program (Outpatient) and Ancillary Payments for the Civil Hospital program. The calendar year 2025 RBRVS fee schedule will be used for payments that have a date of service on or after January 1, 2025. The RBRVS fee schedules for calendar years beginning 1999 through 2024 will be retained in the VISTA database and will continue to be used for payments that have a date of service on or after September 1, 1999 and before January 1, 2025. The 2024 RBRVS fee schedule will be used for any payments entered prior to the installation of this patch that had a date of service on or after January 1, 2025. Existing payments are NOT modified by this patch. The fee schedule amount is only calculated when payments are entered or edited. The PLACE OF SERVICE (POS) code is used to determine if the facility or non-facility practice expense Relative Value Unit (RVU) should be used during RBRVS fee schedule calculations. The list of codes considered facility and non-facility has not changed since 2011. The following four options are used to enter or edit payments for the Medical Fee (outpatient) program: Enter Payment [FBAA ENTER PAYMENT] Multiple Payment Entry [FBAA MULTIPLE PAYMENT ENTRY] Reimbursement Payment Entry [FBAA MEDICAL REIMBURSEMENT] Edit Payment [FBAA EDIT PAYMENT] The following four options are used to enter or edit ancillary payments for the Civil Hospital program: Ancillary Contract Hosp/CNH Payment [FBCH ANCILLARY PAYMENT] Multiple Ancillary Payments [FBCH MULTIPLE PAYMENTS] Patient Reimbursement for Ancillary [FBCH ANCILLARY REIMBURSEMENT] Services Edit Ancillary Payment [FBCH EDIT ANCILLARY PAYMENT] The following option is used to calculate a fee schedule amount without having to enter a payment: Calculate Payment Amount [FBAA FEE SCHEDULE RATE] Components: ----------- UP SEND DATA USER DATE SEC. COMES SITE RSLV OVER FILE # FILE NAME DD CODE W/FILE DATA PTRS RIDE -------------------------------------------------------------------------- 162.96 FEE BASIS GEOGRAPHIC INDEX NO NO YES OVER NO NO 162.97 FEE BASIS CPT RVU NO NO YES OVER NO NO 162.98 FEE BASIS MODIFIER TABLE INDEX NO NO YES OVER NO NO 162.99 FEE BASIS HCFA CONVERSION NO NO YES OVER NO NO Test Sites: ----------- North Texas HCS (#549) Central Texas HCS (#674) Test Sites - SNOW Change Order #: --------------------------------- CHG0581802 - North Texas HCS (#549) CHG0581802 - Central Texas HCS (#674) Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released using a host file. The host file is available at the following location: /srv/vista/patches/SOFTWARE/FB_3_5_190.KID Documentation Title File Name Format -------------------------------------------------------------------- FB_3_5_190.KID FB_3_5_190.KID ASCII Patch Installation: ------------------- Pre/Post Installation Overview: ------------------------------- Pre-Installation Instructions: ------------------------------ This patch may be installed with users on the system; although it is recommended that it be installed during non-peak hours to minimize potential disruption to users. This patch could take up up to several hours to install, and is recommended to be queued to install during off hours. Installation Instructions: 1. Use the Load a Distribution option contained on the Kernel Installation and Distribution System Menu to load the Host file. When prompted to "Enter a Host File:" enter /srv/vista/patches/SOFTWARE/FB_3_5_190.KID 2. From the Kernel Installation and Distribution System Menu, select the Installation Menu. From this menu, A. Select the Verify Checksums in Transport Global option to confirm the integrity of the routines that are in the transport global. When prompted for the INSTALL NAME enter FB*3.5*190. B. Select the Backup a Transport Global option to create a backup message. You must use this option and specify what to backup; the entire Build or just Routines. The backup message can be used to restore the routines and components of the build to the pre-patch condition. i. At the Installation option menu, select Backup a Transport Global ii. At the Select INSTALL NAME prompt, enter your build FB*3.5*190 iii. When prompted for the following, enter "B" for Build. Select one of the following: B Build (including Routines) R Routines Enter response: Build iv. When prompted "Do you wish to secure this message? NO//", press and take the default response of "NO". v. When prompted with, "Send mail to: Last name, First Name", press to take default recipient. Add any additional recipients. vi. When prompted with "Select basket to send to: IN//", press and take the default IN mailbox or select a different mailbox. vii. Repeat step ii for each build in the host file. C. You may also elect to use the following options: i. Print Transport Global - This option will allow you to view the components of the KIDS build. ii. Compare Transport Global to Current System - This option will allow you to view all changes that will be made when this patch is installed. It compares all of the components of this patch, such as routines, DDs, templates, etc. D. Select the Install Package(s) option and choose the patch to install, FB*3.5*190. i. If prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//', answer NO. ii. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', answer NO. iii. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', answer NO a. When prompted 'Enter options you wish to mark as 'Out Of Order':', , press the Enter key. b. When prompted 'Enter protocols you wish to mark as 'Out Of Order':', press the Enter key. c. When prompted 'Delay Install (Minutes): (0 - 60): 0//', answer 0. Post-Installation Instructions: ------------------------------- N/A Back-Out/Roll Back Plan: ------------------------ Due to the complexity of this patch, it is not recommended for back-out, and a restore from a backup of the Transport Global should not be attempted. In the event that the patch installer decides to back out this patch, the patch installer should log a Service Now ticket or contact the Enterprise Service Desk (ESD) at 855-673-4357. Backout or rollback of the software will be a joint decision between the development team, VA site/region personnel and other appropriate VA personnel and will require their concurrence. The development team will need to issue a follow-on patch in order to comprehensively back-out this patch. Routine Information: ==================== No routines included. ============================================================================= User Information: Entered By : Date Entered : JAN 20, 2025 Completed By: Date Completed: MAR 26, 2025 Released By : Date Released : MAR 26, 2025 ============================================================================= Packman Mail Message: ===================== No routines included