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Neuropsychological Testing Crosswalk for 2019 Neuropsychological Testing and Evaluation CPT® Codes CPT® Codes and Descriptors Effective January 1, 2019

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Neuropsychological Testing Crosswalk for 2019 Neuropsychological Testing and Evaluation CPT® Codes CPT® Codes and Descriptors Effective January 1, 2019 Neuropsychological Testing Crosswalk for 2019 Neuropsychological Testing and Evaluation CPT® Codes CPT® Codes and Descriptors Effective January 1, 2019 Professional and Technical Activities Performed by the Neuropsychologist Please note that the new codes do not cross-walk on a one-to-one basis with the deleted codes. The single code, 96118, will now be billed using up to four (4) codes; two (2) codes for Neuropsychological Evaluation Services (96132, 96133) and two (2) for Test Administration and Scoring (96136, 96137). • Evaluation services include interpretation of test results and clinical • Evaluation services must always be performed by the professional prior data, integration of patient data, clinical decision making, treatment to test administration, and may be billed on the same or different days. planning, report generation, and interactive feedback to the patient, • Test administration and scoring services performed by the family member(s) or caregiver(s). neuropsychologist includes time spent to administer and score a - The first hour of neuropsychological evaluation is billed using minimum of two (2) neuropsychological tests. 96132 and each additional hour needed to complete the service • The time spent scoring tests is now considered to be billable time. is billed with code 96133. - The first 30 minutes of test administration and scoring is billed - CPT Time Rules allow an additional unit of a time-based code using 96136 and each additional 30-minute increment needed to be reported as long as the mid-point of the stated amount to complete the service is billed with code 96137. of time is passed. Beyond the first hour (96132), at least - CPT time rules apply to the add-on code if, beyond the first 30 an additional 31 minutes of work must be performed to bill minutes, at least an additional 16 minutes of work is performed. additional unit(s) of the add-on code 96133. NEUROPSYCHOLOGICAL TESTING NEUROPSYCHOLOGICAL TESTING EVALUATION BY PSYCHOLOGIST OR PHYSICIAN SERVICES BY PROFESSIONAL 2018 2019 2018 CPT® Descriptor 2019 CPT® Descriptor CPT® Code CPT® Code Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and 96132* 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 Neuropsychological testing (eg, Halstead-Reitan Neuropsychological Battery, Wechsler Memory Each additional hour (List separately in Scales and Wisconsin Card Sorting Test), per 96133* addition to code for primary procedure) 96118 hour of the psychologist’s or physician’s time, both face-to-face time administering tests to the TEST ADMINISTRATION AND SCORING patient and time interpreting these test results and preparing the report BY PROFESSIONAL Psychological or neuropsychological test administration and scoring by physician or other 96136** qualified health care professional, two or more tests, any method, first 30 minutes Each additional 30 minutes (List separately in 96137** addition to code for primary procedure) * Professional services, such as test selection, clinical decision-making and test interpretation, previously billed with 96119, should now be billed using neuropsychological evaluation codes (96132 and 96133). **Time spent scoring tests is now considered to be billable time. Copyright © 2018 by the American Psychological Association and the APA Practice Organization Current Procedural Terminology® (CPT) copyright 2018 American Medical Association. All Rights Reserved. Copies of the CPT manual can be ordered from the AMA https://commerce.ama-assn.org/store or by calling (800) 621-8335. Page 1 of 3 Neuropsychological Testing Crosswalk for 2019 Neuropsychological Testing and Evaluation CPT® Codes CPT® Codes and Descriptors Effective January 1, 2019 Professional Services Performed by the Neuropsychologist and Technical Services Performed by Technician Please note that the new codes do not cross-walk on a one-to-one basis with the deleted codes. The single code, 96119, will now be billed using four (4) codes; two (2) codes for Neuropsychological Evaluation Services (96132, 96133) and two (2) for Test Administration and Scoring by Technician (96138, 96139). • Neuropsychological Evaluation services include interpretation of test • Evaluation services must always be performed by the professional results and clinical data, integration of patient data, clinical decision prior to test administration, and may be billed on the same or different making, treatment planning, report generation, and interactive days. feedback to the patient, family member(s) or caregiver(s). • Test administration and scoring services performed by the Technician - The first hour of evaluation is billed using 96132 and each includes time spent to administer and score a minimum of two (2) additional hour needed to complete the service is billed with neuropsychological tests. code 96133. - The first 30 minutes of test administration and scoring is billed - CPT Time Rules allow an additional unit of a time-based code using 96138 and each additional 30-minute increment needed to be reported as long as the mid-point of the stated amount to complete the service is billed with code 96139. of time is passed. Beyond the first hour (96132), at least - CPT time rules apply to the add-on code if, beyond the first 30 an additional 31 minutes of work must be performed to bill minutes, at least an additional 16 minutes of work is performed. additional unit(s) of the add-on code 96133. TECHNICIAN ADMINISTERED NEUROPSYCHOLOGICAL TESTING EVALUATION NEUROPSYCHOLOGICAL TESTING SERVICES BY PROFESSIONAL 2018 2019 2018 CPT® Descriptor 2019 CPT® Descriptor CPT® Code CPT® Code Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation 96132* 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 Neuropsychological testing (e.g., Halstead-Reitan Neuropsychological Battery, Wechsler Memory Each additional hour (List separately in addi- 96133* Scales and Wisconsin Card Sorting Test), with tion to code for primary procedure) 96119 qualified health care professional interpretation and report, administered by technician, per hour of TEST ADMINISTRATION AND SCORING technician time, face-to-face BY TECHNICIAN Psychological or neuropsychological test 96138** administration and scoring by technician, two or more tests, any method; first 30 minutes Each additional 30 minutes (List separately in 96139** addition to code for primary procedure) * Professional services, such as test selection, clinical decision-making and test interpretation, previously billed with 96119, should now be billed using Neuropsychological Evaluation codes (96132 and 96133). **Time spent scoring tests is now considered to be billable time. Copyright © 2018 by the American Psychological Association and the APA Practice Organization Current Procedural Terminology® (CPT) copyright 2018 American Medical Association. All Rights Reserved. Copies of the CPT manual can be ordered from the AMA https://commerce.ama-assn.org/store or by calling (800) 621-8335. Page 2 of 3 Neuropsychological Testing Crosswalk for 2019 Neuropsychological Testing and Evaluation CPT® Codes CPT® Codes and Descriptors Effective January 1, 2019 Neurobehavioral Status Exam Please note that CPT® code 96116 has been revised and should no longer be billed in multiple units. • This service includes an initial interview to collect clinical information • CPT Time Rules allow an additional unit of a time-based code to prior to evaluation and test administration and scoring services. be reported as long as the mid-point of the stated amount of time - The first hour of the exam is billed with CPT code 96116 and is passed. Beyond the first hour (96116), at least an additional 31 each additional hour needed to complete the exam is billed minutes of work must be performed to bill additional unit(s) of the using code 96121. add-on code 96121. NEUROBEHAVIORAL STATUS EXAM 2018 2019 2018 CPT® Descriptor 2019 CPT® Descriptor CPT® Code CPT® Code Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgement, e.g., acquired Neurobehavioral status exam (clinical assessment knowledge, attention, language, memory, planning of thinking, reasoning and judgment, e.g., acquired and problem solving, and visual spatial abilities), by 96116 knowledge, attention, language, memory, planning physician or other qualified health care professional, 96116 and problem solving, and visual spatial abilities), both face-to-face time with the patient and time per hour of the psychologist’s or physician’s time, interpreting test results and preparing the report; both face-to-face time with the patient and time first hour. interpreting test results and preparing the report Each additional hour (List separately in 96121 addition to code for primary procedure) Copyright © 2018 by the American Psychological Association and the APA Practice Organization Current Procedural Terminology® (CPT) copyright 2018 American Medical Association. All Rights Reserved. Copies of the CPT manual can be ordered from the AMA https://commerce.ama-assn.org/store or by calling (800) 621-8335. Page 3 of 3.
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