Psychologists' testing codes have changed

As of Jan. 1, practitioners must use new Current Procedural Terminology (CPT) code numbers for psychological and neuropsychological testing services when billing Medicare and all insurance carriers. APA helped to develop the new codes as part of an effort to more accurately describe the work psychologists do when they provide assessment services.

Throughout the new structure, distinctions are made between technical test administration and scoring services and professional evaluation services, as well as between the work performed by a psychologist or neuropsychologist who personally administers tests and technician-administered testing.

The new codes include stand-alone base codes that describe the primary service, as well as add-on codes that describe additional work and time associated with the primary service.

Here are the coding changes psychologists should be aware of:

Neurobehavioral status exams are clinical interview examinations performed by a psychologist or neuropsychologist to assess thinking, reasoning and judgment. Providers should continue to use CPT code 96116 when billing for the first hour and new code 96121 when billing for each additional hour.

Testing evaluation services include the selection of the appropriate tests to be administered; integration of patient data; interpretation of standardized test results and clinical data; clinical decision-making; treatment planning; and reporting and interactive feedback to the patient, family members, or caregivers, when performed. Providers should now use CPT code 96130 to bill for the first hour of psychological testing evaluation services and 96131 for each additional hour. Neuropsychological evaluation services should now be billed using CPT code 96132 for the first hour and 96133 for each additional hour.

Test administration and scoring by a psychologist or neuropsychologist (two or more tests using any method) should now be billed using CPT code 96136 for the first 30 minutes and 96137 for each additional 30 minutes.

Test administration and scoring by a technician (two or more tests using any method) should now be billed using CPT code 96138 for the first 30 minutes and 96139 for each additional 30 minutes.

Single automated test administration should be reported with newly created code 96146 for a single automated psychological or neuropsychological instrument that is administered via electronic platform and formulates an automated result. Psychologists should not use this code if two or more electronic tests are administered and/or if administration is performed by the professional or technician. Instead, the psychologist should use the appropriate codes listed above for test administration and scoring.

Need more guidance on the new codes? Visit the CPT and Diagnostic Codes section of APA Services Inc.(www.apaservices.org).