Score an A for Coding Psychological and Neuropsychological Tests
CPT® codes for psychological and neuropsychological tests include tests performed by technicians and computers (CPT codes 96102, 96103, 96119 and 96120) in addition to tests performed by physicians, clinical psychologists (CPs), independently practicing psychologists (IPPs), and other qualified nonphysician practitioners (NPPs). The payment amounts for tests performed by a technician or a computer are adjusted depending on whether the service was performed in a facility or non-facility setting.
Psychological tests are generally used to assess an number of things, including behavior, personality, and IQ. Neuropsychological tests are used to assess brain activities such as learning and memory.
Supervision Requirements Depend on Provider
All diagnostic tests are assigned a certain level of supervision. Generally, diagnostic tests require a physician to provide the appropriate level of supervision for such tests. That is, the physician must either provide general, direct, or personal supervision. However, for diagnostic psychological and neuropsychological tests (96101-96120), there is a regulatory exception (at 42 CFR 410.32(b)(2)(iii)) that allows either a CP or a physician to provide the required general supervision for diagnostic psychological and neuropsychological tests. NPPs, such as nurse practitioners (NPs) and clinical nurse specialists (CNSs), and physician assistants (PAs), who personally perform diagnostic psychological and neuropsychological tests are excluded from the supervision requirements for diagnostic tests. However, they must meet the collaboration and physician supervision practice requirements under their respective benefits.
Multiple Tests Can Be Billed on Same Date for Same Patient
If several different clinically appropriate tests are administered on the same date to the same patient (whether by a physician/psychologist, technician, or by computer), then the appropriate testing codes for psychological testing or neuropsychological testing can be billed together. More than one code can also be billed when several distinct tests are administered to the same patient on the same date of service via technician (96102/96119) or computer (96103/96120), and the physician/psychologist needs to integrate the separate interpretations and written reports for each of these tests into a comprehensive report.
The technician-administered code (96102/96119) is billed based on the number of hours the technician spends face to face with the patient. The computer-administered testing code (96103/96120) is billed once, regardless of the time spent completing the tests.
Interpretation is Included in the Code
The physician/psychologist is expected to bill for the work performed on that date of service. If all of the testing is conducted by a physician/psychologist, then the professional code should be billed for the time spent on test administration, interpretation, and report preparation, as well as integration of previously interpreted test results into a comprehensive report (96101 or 96118). Only the appropriate technician-administered or computer-administered codes can be billed on the actual date of service if a physician/psychologist interprets and writes a report on individual tests administered by a technician (96102 or 96119) or computer (96103 or 96120). The interpretation and reporting of the individual test results by the physician/psychologist, which may sometimes occur on a different date than the testing date, are already captured in the payment for the technician and computer-administered codes.
Testing vs. Scoring
The computer codes (96103 and 96120) can only be billed when a computer is used to administer tests. The codes cannot be billed if the computer is used only to score tests. For paper-and-pencil tests, the physician/psychologist should bill appropriately for any other service provided.