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Testing

Jill 4 years ago in Codes/Rates/Diagnosis Modules updated by Richard Sethre, Psy.D., L.P. 4 years ago 2

Good morning!  I am wondering what experience others have had with billing the testing CPT codes. The specific tests I am looking at would be the MMPI and the MAPI.  I believe this would fall under the 96101?  Some of the questions I have on this is - what is the reimbursement rate like?  How many hours are you able to bill for?  Are you paid separately for the test administration and the write-up or is this one code?  Does this need to be billed along with a DA?  If anyone has a chance to give their thoughts on this it would be greatly appreciated!

Thanks & have a great weekend!

Jill

Check the guidelines on the client's plan as a start. Some may require a PA for testing.

These are very basic questions. This sort of information should be covered during training in graduate school for testing, which should include several classes and supervised practice in selecting, administering, and interpreting test results and writing the report.  Choosing the CPT billing code depends upon several factors, including the test(s) used, the purpose of the testing, and how the tests are administered (by a "qualified health professional"' by a technician, or by computer). The amount of time billed as depends upon several factors, including whether a a DA  has already been done, your testing materials expenses (the fee for using an administration of the MMPI, for example), time spent for interpreting and writing the report, and whether time was spent providing feedback to the patient or parents.

Overall, it is important to know whether your license allows for testing as part of the "scope of practice" according to your licensing board,  whether you have adequate training in order to meet your board's requirements to do testing, and whether you have adequate training for providing testing services to the population that you serve. You also, as someone else noted, need to be knowledgeable about the testing policies of the insurance company that you would be submitting your claim to.