Skip to main content
COVID-19

Code Bundling Rules for PET/MRI Services

Review how Horizon considers reimbursement of code combinations of eligible PET/MRI services when rendered on the same date of service.

Procedure code 73718 is bilateral eligible.

Code Code Rule Formula Used for Reimbursement
78812 70540
73218
71550
74181
72195
73718
When the code from column A is billed with one or more codes from column B 100% for the PET exam, 50% for the MRI with the highest RVU and 25% for any additional MRIs with lessor RVUs