If you’re billing for neurocognitive testing in your practice, here’s what you need to know before January 1, 2019
The Centers for Medicare and Medicaid Services (CMS) has announced that effective January 1, 2019, the Current Procedural Terminology (CPT®) codes for psychological and neuropsychological testing will change. Here’s an overview of the upcoming changes.
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- BrainCheck users are currently utilizing CPT codes 96119 and 96120 for BrainCheck administration, if assisted by a technician or administered solely by computer.
- Those codes will be eliminated and replaced with new CPT codes that separate test administration from test interpretation.
- These new codes have potential for greater reimbursement and validate the disparate tasks that were being performed.
Test Administration
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- CPT 96138 is designated as “Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; first 30 minutes.”
- BrainCheck is a screening battery consisting of five component tests, with administration by a technician who assists the patient in completing the test. The ‘any method’ designation includes computer-based tests.
- This new code matches the administration of BrainCheck and should be used for most test administrations after January 1, 2019.
Test Interpretation and Feedback
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- Previously, BrainCheck advised using CPT code 96118 for the interpretation of results, when provided in a separate visit and integrated with results from other tests.
- Code 96118 will be eliminated and replaced with CPT code 96132.
- CPT 96132 is designated as “Neuropsychological testing evaluation services by physician or other qualified healthcare professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report and interactive feedback to the patient, family member(s) or caregiver(s), when performed; first hour.”
In part two, we’ll cover the rationale behind these changes, what to expect with regards to reimbursement amount and what you need to do to prepare for the transition.
The information provided in this document was obtained from third-party sources and is subject to change without notice as a result of changes in reimbursement laws, regulations, rules, and policies. All content on this document is informational only, general in nature, and does not cover all situations or all payers’ rules and policies. This content is not intended to instruct medical providers on how to use or bill for healthcare procedures, including new technologies outside of Medicare national guidelines. A determination of medical necessity is a prerequisite that BrainCheck, Inc. assumes will have been made prior to assigning codes or requesting payments. Medical providers should consult with appropriate payers, including Medicare fiscal intermediaries and carriers, for specific information on proper coding, billing, and payment levels for healthcare procedures. This information represents no promise or guarantee by BrainCheck, Inc. concerning coverage, coding, billing, and payment levels. BrainCheck, Inc. specifically disclaims liability or responsibility for the results or consequences of any actions taken in reliance on this information.
