In line with the implementation of the Relative Value Scale (RVS) 2001, the following policies and guidelines for surgical operations performed in primary hospitals are being issued:
- Primary care hospitals shall only be compensated for simple surgical operations (RVU of 30 and below). However, they may be allowed to perform the repair of an episiotomy (CODE=59409) during the first normal vaginal delivery.
- Any operation performed beyond the accredited capability of primary hospitals shall be denied except when the same is done in an emergency case. In all surgical procedures done in accredited primary hospitals, the maximum payment for hospital charges (Drugs/Medicines, X-ray/Laboratory and Operating Room) and the surgeon's professional fee shall be based on RVU of 30, including emergency cases.
- As the benefit value of vasectomy and litigation/transection of fallopian tubes is below the preset peso value of a procedure with RVU 30, these procedures are to be construed as simple surgical operations.
Please be guided accordingly.
Adopted: 05 Feb. 2002
(SGD.) FRANCISCO T. DUQUE III, MD, MSc.
President and CEO
