Insurance Reimbursement

For your convenience, we have compiled information regarding reimbursement for psychological tests. The information provided is not intended as specific coding or legal advice. Those who seek reimbursement for the use of our tests should follow the direction of coding and legal experts familiar with the policies of the specific third party payer from whom they will seem the reimbursement.

Psychologists and other mental health professionals, click here.
Medical doctors and other medical professionals, click here.

Other sources of information for psychological test reimbursement

2006 Testing Codes Toolkit
The APA (American Psychological Association) Practice Organization has published a toolkit which contains information and materials to help you learn about proper use of the psychological and neuropsychological CPT testing codes and payment for these codes. The toolkit can be found at http://www.apapractice.org/apo/toolkit.html.

CMS Manual System: Psychological and Neuropsychological Tests
http://www.cms.hhs.gov/transmittals/downloads/R85BP.pdf

MLN Matters Summary Article: Psychological and Neuropsychological Tests
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5204.pdf

New Medicare Billing Rules for Testing Services Effective 10/1/2006
Read more about a new rule implemented by Medicare’s National Correct Coding Initiative (NCCI) that will impact those who use technicians and/or computers for test administration under psychological testing codes. This information, compiled by the APA Practice Organization, can be found at: http://www.apapractice.org/apo/in_the_news/new_medicare_billing.html#.

CPT® Professional Edition manual
The new codes are published in the CPT® 2006 Professional Edition manual, which is available at AMA (American Medical Association) at 1-800-621-8335.

CPT® Information Services (CPTIS)
This is a service offered by AMA. AMA members receive complimentary subscription to CPTIS, while for others, this is a fee-for service resource. The Coding Helpline is 1-800-634-6922.

Articles

A number of our Bridging the Gap newsletter articles regarding assessments and insurance reimbursement are available:

• New CPT® Codes for Psychological Testing
• Denials Reversed: New CPT Health and Behavior Codes Gain Acceptance
• New Billing Codes Available for Psychological Services with Medical Patients
• New Health & Behavior CPT Billing Codes-An Update

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