Does anyone know the justification for Medicare pricing 90791 higher than 90792. This is very surprising to me because 90792 includes evaluation with medical services therefore, I would think it would price higher because it includes the E/M. Note: no E/M code can billed with 90791 or 90792.
I know the work RVU is higher for 90792 but the PE RVU is lower which is causing the 90791 to have a higher Medicare rate but this still doesn't make since since the 90792 includes the medical services.
90791- Psych diag evaluation (Work RVU 2.80 and NF PE RVU 1.52)= higher Medicare rate then 90792
90792- Psych diag evaluation with medical services (Work RVU 2.96 and NF PE RVU .58)= lower Medicare rate then 90791
Thanks in advance!
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