A clinician mentions, in passing, that she’s been getting more new patients lately — patients she doesn’t recognize and didn’t expect. A colleague has a lighter new-patient load but a higher concentration of procedure visits. It wasn’t a deliberate decision. The schedule just evolved that way. 

In most practices, patient assignment and RVU attribution work smoothly until they don’t. Problems are discovered gradually: a scheduling coordinator routes new patients based on who has open slots, not who has the right panel capacity. A provider raises a question about how RVUs are being split on a shared visit. A comp model adjustment creates a new incentive that no one’s thought through from a scheduling standpoint. Without a written standard, these situations get resolved informally and inconsistently. 

Why a written policy matters here 

Patient assignment and RVU attribution involve patient access, provider compensation, and scheduling operations. When the rules aren’t documented, three things tend to happen. 

1. Schedulers make judgment calls with no guidance: They default to availability, provider preference, or past habit, none of which is an appropriate basis for new-patient distribution. 
2. RVU disputes become personal: Disagreements about shared visits or split encounters get escalated and handled ad hoc. The same situation gets resolved differently depending on who raises it and when. 
3. Patterns go undetected: If no one is tracking new-patient distribution or visit mix by provider, preferential scheduling can develop over time (even unintentionally) without anyone flagging it. 

A written policy gives administrators and scheduling leads a shared reference point. It sets expectations before problems arise, not after. 

What the policy template covers 

This template is designed for practice administrators and operations leaders in ambulatory and outpatient settings, particularly those managing multi-provider practices where compensation includes a wRVU component. 

Our Patient Assignment and RVU Attribution Policy Template includes: 

• Guiding principles that establish patient assignment as a clinical and operational decision — not a financial one. No provider may selectively accept or decline patients based on RVU value, visit complexity, or expected reimbursement. 
• Assignment protocols for new patients, based on current panel size, appointment availability, and language or subspecialty needs. Established patients may not be redirected for RVU-related reasons. 
• Defined exceptions for situations where variation is appropriate — procedure-only scope, global surgical periods, or clinic templates limited to specific encounter types. The policy requires these exceptions to be pre-documented in the clinic schedule. 
• RVU attribution rules that tie wRVUs to the rendering provider, consistent with billing documentation and clinical notes. Shared visits must follow CMS or payer-specific rules. Attribution disputes go to the medical director and administrative leadership. 
• Oversight and enforcement provisions, including routine audits for outliers in new-patient intake or visit mix, and a defined review process for any pattern that suggests preferential scheduling based on RVU considerations. 

It is most useful when: 

• Your practice is adopting or revising a productivity-based compensation model and needs scheduling policy to match. 
• You have received provider complaints (formal or informal) about scheduling fairness or RVU credit on shared visits. 
• You are onboarding new providers and want to document expectations. 
• A compliance review or payer audit has raised questions about your visit documentation or attribution practices. 
• Your scheduling team is making assignment decisions without clear criteria, and you want to standardize their process. 

Getting started 

Most practices already have informal norms around patient assignment and RVU attribution. The value of a written policy is that it makes those norms explicit — and gives administrators a consistent standard to apply when situations fall outside the routine. 

Download the MGMA Patient Assignment and RVU Attribution Policy Template to give your scheduling team clear criteria, your providers a fair and documented process, and your leadership a foundation for ongoing review.