December 2020

Billing Reminders for Psychological and Neuropsychological Testing

Below are billing reminders for psychological and neuropsychological testing. Proper coding of the specific services provided may help expedite claim processing and support accurate claim payment. Blue Cross and Blue Shield of Illinois (BCBSIL) may reach out to you by phone or email when we note incorrect coding patterns. 

The following are common Current Procedural Terminology (CPT^®) codes for billing psychological and neuropsychological testing services:

Billing Reminders

• According to CPT guidelines, codes 96130-96133 and 96136-96139 are for a psychological or neuropsychological assessment. BCBSIL doesn’t recognize these codes for brief screenings or assessments to monitor patient progress during routine therapy sessions or psychiatric follow-up visits unless followed by a comprehensive assessment. CPT guidelines provide specific brief screening codes for these purposes.
• Base codes (96130, 96132, 96136, 96138) may be used only once per testing episode. If testing occurs across multiple days, the base code may be used one time at the start of testing.
• Determine whether the testing is mainly psychological or neuropsychological. Psychological and neuropsychological evaluation codes shouldn’t be applied to the same episode of service.
• Time-based CPT codes billed by one servicing provider shouldn’t overlap. For example, if a Beck Depression Inventory is administered during a 60-minute therapy session, a 60-minute therapy code and a brief behavioral assessment code may be billed. An additional half hour or one hour of testing shouldn’t be billed since only 60 minutes was spent with the member. 

To learn more about Psychological and Neuropsychological Testing, refer to the Clinical Payment and Coding Policy page on our Provider website.

CPT copyright 2019 American Medical Association (AMA). All rights reserved. CPT is a registered trademark of the AMA.

This material is for informational/educational purposes only and is not intended to be a substitute for the independent medical judgment of a physician or a definitive source for coding claims. The reference to any particular brand, type or method of testing is solely for informational purposes and is not, and should not be, construed as an endorsement, representation or recommendation for any particular test. Physicians and other health care providers are encouraged to use their own best medical judgment based upon all available information and the condition of the patient in determining the best course of treatment. Health care providers are instructed to submit claims using the most appropriate code(s) based upon the medical record documentation and coding guidelines and reference materials.