Billing and Coding: Psychological and Neuropsychological Testing

Psychological and neuropsychological testing is covered when testing is medically necessary and the results directly inform diagnosis, prognosis, treatment planning, treatment goals, efficacy, or disposition; specific testing types (aphasia assessment, cognitive performance, developmental/behavioral screening, neurobehavioral status exams) map to listed CPT codes. Testing that does not affect the plan of care or testing performed after an established Alzheimer's disease diagnosis is not covered. Providers must be Medicare-enrolled and state-licensed, document clinical rationale and supervision, combine multi-day testing time and meet the minimum time thresholds (e.g., 31 minutes for per-hour codes).

"Psychological or neuropsychological testing is medically necessary when results are used to make specific diagnoses or prognoses that directly inform treatment planning, treatment goals, treatment ..."