Psychological and Neuropsychological Testing

Medically necessary psychological and neuropsychological testing is covered when results will affect medical management—examples include evaluation of mild/questionable cognitive deficits, diagnostic clarification combined with clinical and imaging data, pre-surgical assessments, monitoring treatment effects, capacity evaluations, rehabilitation planning, and assessment in children with developmental concerns. Testing must be preceded by a documented neurobehavioral status examination and administered/scored/interpreted by qualified professionals (or by a technician under direct supervision). Screening-only tests, self-administered inventories, tests for nonmedical educational/vocational purposes, tests when the patient cannot meaningfully participate, and repeats that do not influence medical decision-making are not covered.

"Neuropsychological testing is medically necessary when mild or questionable deficits are detected on standard mental status testing or clinical interview and testing is needed to establish the pres..."