Please Note: The Gap License can not be purchased separately online. You can either order the 2016 RBRVS EZ-Fees (any version) CD ROM or Online Download with the Gap License or add the Gap License to your existing 2016 RBRVS EZ-Fees order by calling customer service. Each additional RBRVS EZ-Fees user requires a Gap License.
Although RBRVS is the most widely used RVS (Relative Value Scale) it does not provide fee information for procedures and services not paid by Medicare. This results in “gaps” in medical fee schedules. Private payers including managed care who adopt RBRVS methodology are forced to price their gap claims on an individual basis or use alternative non RVS methodologies. Some simply pay out the claim while other defer to a review panel, bypassing the regular adjudication. This slows down the claims review process and often results in disputes and appeals with payers.
RBRVS EZ-Fees Gap Codes are provided under a license agreement with Optum 360 publishers of The Complete RBRVS. We have selected this gap solution based on their reputation and experience in developing accurate, user-friendly coding and reimbursement guidelines for health care providers, consultants, and payers.
Integration of Gap Codes into RBRVS EZ-Fees is seamless. Simply enter your Gap license number under (Help-Upgrades-Gap License) and all Gap codes will appear on the main screen with a status indicator “g”. Since Gaps codes were designed for the RBRVS formula using the same CF (Conversion Factor) and GPCIs (Geographic Practice Cost Indicators) there is no math nor adjustments.