decisionhealth Newsletters, Coder Pink Sheets - 2012 Issue 12 (December)
Practice expense is the reason psych evaluation fees appear misvalued
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Article Overview
This article reviews a 2013 Medicare physician fee schedule issue involving CPT psychiatric diagnostic evaluation services. It explains the general reason the payment relationship looks unusual, discusses how CMS and the AMA RUC contributed to the valuation process, and notes that the values were treated as interim and subject to later review. It is relevant to coders, billing staff, and practitioners working with psychiatry-related physician fee schedule updates.
Why This Topic Matters
Understanding this valuation issue helps billing and coding professionals interpret Medicare fee schedule differences for psychiatry services and stay alert to interim pricing changes that may affect reimbursement.
What You Will Learn
- Why a Medicare fee schedule may show an unexpected payment relationship for psychiatry evaluation services
- How CMS and the AMA RUC influenced the valuation process
- Why interim valuations can change in future fee schedule updates
- How CPT code changes affected psychiatric diagnostic evaluation reporting in 2013
Who Should Read This
- Medical coders
- Billing specialists
- Practice managers
- Psychiatry providers
- Revenue cycle professionals
Codes Discussed
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