Wiki Help needed with new changes from 96111 to 96112-96113

TTcpc

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Hello,

I'm hoping someone may have the same situation or can provide some guidance/opinion on the change from the 96111 which was deleted and replaced this year with the 96112-96113. In our pediatric practice we have a staff member who has a Master of Arts in Educational Psychology who is trained and oversight provided by our Developmental physicians. The problem I am running into is that the addition of "physician or other qualified health care professional" this year to the new codes would basically now exclude us from using her to administering these tests. Our workflow in that clinic is that the patient/parent come in and see this staff member who administers/scores the testing and then they go directly to the physician afterwards and spend additional time with them in observation and discussion. The testing 96111 as well as an office visit charge was all billed under the MD. Now we are basically being told because of this change in verbiage that we would need to get rid of this staff person and put it all on the physician.

I'm curious as to how other clinics have handled this or if you have used other staff to perform the developmental testing.

Thank you

T
 
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