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Medicare coverage clarification on 96118 (neuropsych testing)

  1. Default Medicare coverage clarification on 96118 (neuropsych testing)
    Medical Coding Books
    Here's the situation -- we have a Clinical Psychologist who needs to do testing (96118) on a patient; however he previously tested her also using 96118 in June 2010. I know that Medicare only allows a maximum of 8 units per year, but can't get a clear answer on billing the same testing code. I was able to find this statement "Medicare will not pay twice for the same test or the interpretation of tests."

    Question -- does anyone know if this is a yearly rule? Meaning, we can only bill the 96118 once per year -- or does it mean that we can only bill it once and never again? If anyone has the answer to this I would really appreciate any help. Thanks!

  2. #2
    You can bill the code repeat times. What they are saying is they will pay for 8 qty of 96118 per year. So if your doc already billed let's say 4qty last June, that means he can bill 4 more before that exact date of service in June. After June, you will start over with 8 more allowed qty. Make sense?

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