To access insurance policies and authorization requirements for billing CPT codes 96136, 96138, 96132, and 99483, select your state tab and review the listed guidelines specific to your area.
- 96138: Neurocognitive test administration by a technician – first 30 minutes (minimum 16 minutes).
- 96136: Neurocognitive test administration by a medical professional – first 30 minutes (minimum 16 minutes).
- 96132: Test interpretation and medical decision-making – first hour (minimum 31 minutes).
- 99483: Cognitive care planning (standalone visit with no time requirement).
- For 96138 (or 96136) and 96132 billed separately: No modifiers are needed.
- When billing 96138 (or 96136) and 96132 on the same day: No modifiers are needed; use the same ICD-10 code for both.
- When billing 96138 (or 96136) and 96132 on the same day as an E&M visit: Append a 59 modifier to BOTH 96138 (or 96136) and 96132. The E&M code must use a different ICD-10 code.
No, 99483 must be billed as a standalone code and cannot be combined with other CPT codes. It can only be billed once every six months (180 days)
- Medical reason for testing.
- ICD-10 code.
- Total time spent with the patient.
- Reason for testing.
- Tests administered (e.g., Trails A/B, Stroop).
- Test results and interpretation.
- Recommendations for interventions.
- Diagnosis or rule-out of suspected diagnosis.
- Feedback summary to the patient and/or caregiver.
- Total time spent with the patient.
- BrainCheck Screen™
- BrainCheck Assess™
- BrainCheck Plan
- A Library of Common Screeners (BEHAV5+, Dementia Severity Rating Scale, Functional Assessment Staging Tool, Geriatric Depression Scale, Lawton-Brody IADL, PRAPARE, Safety Assessment Checklist, PTSD Checklist for DSM-5, PROMIS Global-10, Patient Health Questionnaire-9, NPI-Q+, Katz Index of IADL, Generalized Anxiety Disorder-7, End of Life Checklist, Caregiver Profile)
BrainCheck Screen™ is a quick cognitive screening tool designed for early detection of cognitive impairment.
- Takes about 3-5 minutes to complete.
- Helps identify signs of cognitive decline but does not provide a full diagnostic picture.
- Can be administered in-clinic or remotely with easy-to-understand reports.
BrainCheck Assess™ is a comprehensive cognitive assessment providing detailed insights into multiple cognitive domains.
- Takes about 10-15 minutes to complete.
- Measures memory, attention, executive function, processing speed, and more in depth.
- Provides more detailed reporting to guide diagnosis and treatment plans.
Watch this video for a tutorial.
Provider App Care Plan Orders
Here are the uses for each care plan order:
- BrainCheck Plan – Use when:
- You are creating a care plan for a patient who has completed an Assess within the last 42 days.
- You need to create a care plan for a patient who already has cognitive deficits identified and you feel they won’t be able to successfully complete an Assess.
- Plan + Assess – Use when:
- You created a care plan for a patient 6 months ago and need to create an updated one with current Assess results.
Athena-Integrated Care Plan Orders
Here are the uses for each care plan order:
- BrainCheck Care Plan without Assess (Athena order group name: Care Plan) – Use when:
- You are creating a care plan for a patient who has completed an Assess within the last 42 days.
- You need to create a care plan for a patient who already has cognitive deficits identified and you feel they won’t be able to successfully complete an Assess.
- BrainCheck Cognitive Care Plan (Athena order group name: Assessment and Care Planning for Patient with Cognitive Impairment) – Use when:
- You created a care plan for a patient 6 months ago and need to create an updated one with current Assess results.
Did you know?
A good night’s sleep helps consolidate memories and improve learning, working as the brain’s personal organizer.
