Enterprise E/M Compliance
Across Every Care Setting.
RVU Guard hardens documentation and defends wRVUs for institutional medical groups — from outpatient clinic Modifier 25 bundles, to high-acuity ED MDM scoring, to inpatient Critical Care time tracking. One engine, every setting, defensible revenue.
One compliance engine. Every point of care.
Whether your physicians work in clinics, emergency departments, or hospital wards, RVU Guard models the unique coding friction of each setting — and hardens the chart before the claim ever leaves.
Clinic & Same-Day Surgery
Modifier 25 bundling is where most outpatient revenue leaks. RVU Guard isolates E/M from procedural documentation, validates separate MDM justification, and hardens the note so payers can't deny the pair.
High-Acuity ED Visits
ED charts move fast — but CMS MDM rules don't bend. The engine scores problem complexity, data review, and risk of complications in real time, surfacing defensible levels from 99281 through 99285 without slowing clinicians down.
Hospital & Critical Care
Inpatient documentation spans admission, subsequent care, and time-based critical care. RVU Guard tracks time thresholds, validates medical necessity, and ensures Critical Care minutes map cleanly to the billable unit.
Three layers between your group and a denied claim.
RVU Guard isn't an LLM scribe — it's a compliance engine built for the scale, risk, and documentation diversity of institutional medical groups.
MDM Audit Engine
Deterministic CMS 2021/2023 logic evaluates Problems, Data, and Risk independently — then surfaces the defensible E/M level with line-item reasoning you can paste into the chart.
Structural Hardening
Identifies the exact documentation gaps blocking the next level — missing chronic condition severity, undocumented data review, unstated prescription management — and rewrites them inline.
Defensive Ledger
Every audit is sealed into an immutable evidentiary record with timestamp, MDM rationale, and citation trail — ready for payer review, RAC audit, or compliance committee.
One coding level. Significant revenue.
The difference between a 99213 and a 99214 isn't paperwork — it's roughly +0.53 wRVUs per encounter. Across a multi-provider group, that compounds into hundreds of thousands in defensible compensation that proper documentation alone unlocks.
| CPT Code | MDM Level | wRVU Weight | Δ vs 99213 | Est. $ Impact* |
|---|---|---|---|---|
| 99212 | Straightforward MDM | 0.70 | -0.27 | −$9.73 |
| 99213Baseline | Low complexity MDM | 0.97 | — | — |
| 99214 | Moderate complexity MDM | 1.50 | +0.53 | +$19.10 |
| 99215 | High complexity MDM | 2.11 | +1.14 | +$41.09 |
*Estimated using 2024 CMS conversion factor of $36.04 per wRVU. Actual reimbursement varies by payer contract and geography.