Voluntary program that provided a financial incentive to physicians and other eligible professionals who successfully reported quality information related to services provided under the Medicare Physician Fee Schedule between July 1 and December 31, 2007. It was established when President Bush signed the Tax Relief and Health Care Act of 2006 (TRHCA), Section 101 Title I.

Medical services rendered by a physician to a patient. This may include surgery, consultation, home visit, office visit, hospital visits, and institutional visits. Physician services given while in the hospital that appear on the hospital bill are not included.

In-hospital, office, and home face-to-face visits by a physician. Most health plans provide insurance payment for visits when a patient is ill or has been injured.

One of the three components used in the formula to develop relative value units (RVUs) for each medical service performed. This corresponds to the value of the physical skill, mental effort, judgment, and time required to perform a service. The other two components are practice expense and the cost of professional liability insurance. These three RVUs are then adjusted according to geographical area and used in a formula to determine the resource-based relative value scale (RBRVS) for the Medicare fees published annually in the Federal Register.

Facility for diagnosis and treatment of outpatients where (1) a physician gives medical services at all times, (2) each patient is assigned to receive care from a clinic doctor, and (3) nonphysician services are under medical supervision.

Type of managed care plan owned and controlled by large physician groups. These plans may offer enrollees a choice of programs with a financial incentive to use network physicians (e.g., exclusive provider organization [EPO], preferred provider organization [PPO], or point-of-service [POS] plan).

Initiative of the National Recovery Project via the Office of the Inspector General that established guidelines for payments for resident doctors that are employed at teaching facilities treating Medicare patients. Such services are performed under Medicare Part B but are paid for as part of Medicare Part A.

A reference procedural code book using a numerical system and description for procedures for reporting and billing medical services and procedures. It is established and owned by the American Medical Association.

Annual publication that lists prescription drugs and diagnostic products and is used by physicians as a reference tool.

Compilation of each physician’s charges for specific professional services and the payments made to the physician over a given period of time.