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2019 Psychological Testing Codes

Andrea Drews 1 year ago in Codes/Rates/Diagnosis Modules updated by Vicki/Billing 1 year ago 6

Has anyone had any luck finding the Medicare and MN Medicaid Fee Schedule for the new codes 96130, 96131, 96136, 96137, 96138 or 96139?

+1

It was on the last DHS update:

The following codes cannot be used in 2019: 96101, 96102, 96103, 96118, 96119 and 96120. See the chart below for new 2019 codes and changes.

2019 Neuropsychological CPT Code Changes

Service Description

2018 Procedure code

2018 unit allowed

2019 Procedure code

2019 unit allowed

Neurobehavioral status exam both face-to-face time with the patient and time interpreting test results and preparing the report by physician or other qualified health care professional. First hour.

96116

1 hour

96116
(same as 2018)

1 hour

Each additional hour

None

None

96121

1 hour

Neuropsychological testing evaluation services including 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 member(s) or caregiver(s) by physician or other qualified health care professional. First hour.

96118

1 hour

96132

1 hour

Each additional hour

None

None

96133

1 hour

Neuropsychological test administration and scoring of two or more tests, any method, by physician or other qualified health care professional. First 30 minutes.

None

None

96136

30 minutes

Each additional 30 minutes

None

None

96137

30 minutes

Neuropsychological test administration and scoring of two or more tests, any method, by a technician. First 30 minutes.

96119

1 hour

96138

30 minutes

Each additional 30 minutes

None

None

96139

30 minutes

Neuropsychological test administration, with single automated, standardized instrument via electronic platform with automated results only.

96120

1 session

96146

1 session

2019 Psychological CPT Code Changes

Service Description:

2018 Procedure code

2018 unit allowed

2019 Procedure code

2019 unit allowed

Psychological testing evaluation services including 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(s) or caregiver(s) by physician or other qualified health care professional. First hour.

96101

1 hour

96130

1 hour

Each additional hour

None

None

96131

1 hour

Psychological Test administration and scoring of two or more tests by physician or other qualified health care professional. First 30 minutes.

None

None

96136

30 minutes

Each additional 30 minutes

None

None

96137

30 minutes

Psychological test administration and scoring of two or more tests, any method, by technician. First 30 minutes.

96102

1 hour

96138

30 minutes

Each additional 30 minutes

None

None

96139

30 minutes

Psychological test administration, with single automated, standardized instrument via electronic platform with automated results only.

96103

1 session

96146

1 session

(pub. 12/28/18)

Oh sorry, you said fee schedule. I think the crosswalk is the same but the psychomed's were having a community meeting because of the confusion on the 30 minute add-on codes.  How does everyone interpret that part?

That is also part of our confusion.  I just found out about these changes this morning, so I am trying to catch up to speed on these codes, etc.  Any insight would be helpful.

+1

We are trying to navigate this as well.  

There is some information on the American Psychological Association website at www.apaservices.org under practice, then reimbursement.  There is an hour long webinar that one of our psychologists watched and reported it had some helpful information.  I haven't been able to watch the webinar yet so I apologize that I can't summarize the content.  We have an upcoming staff meeting scheduled within our agency and if we come up with additional answers I can report back here.

Hi  I have a question regarding the use of 96130.  When billing only a TOVA do I use this code plus 1 unit of 96146.  I am unsure if you need to do two tests in order to use 96130.  Thanks!