Wiki 96116

[tcb2021]

Has anyone here had to bill out a 96116 before? Is this a commonly used code? Do you often see it used in primary care or just specialty?
Thanks

 

[amyjph]

This is a code normally seen in psychology or neuropsychology practices.

https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57481

https://providernews.anthem.com/georgia/articles/coding-tip-for-psychological-and-neuropsychological-testing-3606

 

[TThivierge]

Hi Tcb2021
Yes LPC, MH assistant, psychologist, LCSW, QHP can use CPT 96116 but it needs to be described assessment format . Usually for dx codes of dementia, or memory lacking, stroke patients or child develop problems as type of patients. There are list of beh.health assessments like MSE, MMSE, PHQ9 can be noted in record.
I hope helped you too
Lady T

 

[amyjph]

Hi Tcb2021
Yes LPC, MH assistant, psychologist, LCSW, QHP can use CPT 96116 but it needs to be described assessment format . Usually for dx codes of dementia, or memory lacking, stroke patients or child develop problems as type of patients. There are list of beh.health assessments like MSE, MMSE, PHQ9 can be noted in record.
I hope helped you too
Lady T

Use caution - the PHQ9, MSE and MMSE may not necessarily be reported with code 96116. Specifically, PHQ9 is not reported with 96116.

It would be more common in primary care to see 96110, 96127 for example.