Cpt 96131 Neuropsychological evaluation services should now be billed using CPT code 96132 for the first hour and 96133 for each additional hour. It is an add-on code, meaning it is billed in conjunction with another primary testing code, such as 96130, which covers the first hour of such CPT 96131 refers to psychological testing evaluation services conducted by a physician or other qualified healthcare professional. Includes payer rules, documentation tips, and coding strategies. May 30, 2025 · Learn how to bill psychological testing services using CPT codes 96130–96146. Jan 23, 2019 · CPT 96130 - Psychological Testing Evaluation Service Explanation: A psychological testing evaluation by a physician or other qualified healthcare professionals is now billed using two CPT codes: 96130 and 96131. These exam-ples are meant to be a guide for how to code, document, and bill for testing services using the new revised CPT® code set implemented on January 1, 2019. This guide explains their correct use, time units, and documentation tips. CPT 96132 and 96133 focus on tests about thinking and brain functions. There are distinct testing evaluation Providers should now use CPT code 96130 to bill for the first hour of psychological testing evaluation services and 96131 for each additional hour. Both codes cover the same professional services, including data integration, test interpretation, and treatment planning. For example, CPT 96130 and 96131 apply to psychological tests that focus more on emotions and behavior. Jun 13, 2025 · What are the key differences between CPT codes 96130 and 96131? CPT code 96130 is the base code for the first hour of psychological testing evaluation, while 96131 is an add-on code for each additional hour. References to CPT or other sources are for definitional purposes only and do not imply any right to reimbursement. Key Components of Accurate Coding and Documentation Coding must be correct to avoid denied claims and get paid the right amount. The CPT® Code 96131 refers to psychological testing evaluation services conducted by a physician or other qualified healthcare professional. One such code, 96130, covers psychological testing evaluation services, including your time spent on interpretation and reporting of tools like MindMetrix. The office I bill for have one date of service for 96130 and another date of service for 96131, so what is the correct procedure for billing these CPT codes. 3 days ago · CPT® Code 96131 in section: Psychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation 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 Official description of CPT 96131: Psychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, family Dec 7, 2021 · To qualify as 1 hour, when billing CPT 96130 or CPT 96131, the time must be a minimum of 31 minutes, and includes the total time integrating, interpreting, and discussing results, not just face-to-face time with the patient. They allow for an assessment of a patient's cognitive and behavioral Oct 18, 2024 · 96131 – Psychological testing evaluation services (each additional 60 minutes) Description: This add-on code is used for every additional hour of psychological testing and evaluation beyond the first 60 minutes covered by 96130. Jun 16, 2025 · CPT codes 96130 and 96131 are used for psychological testing services. 2019 Psychological and Neuropsychological Testing CPT® Codes, Descriptions & Total RVUs CPT® Codes, Descriptors and Non-Facility RVU Values Effective January 1, 2019 Mar 21, 2025 · Understanding psychological billing is crucial for healthcare providers and their billing support staff. Updated for 2025. Discover insurance psychological and neuropsych testing reimbursement rates in 2025, what psych testing CPT codes to bill, and what they pay! We would like to show you a description here but the site won’t allow us. . CPT Time Rule For time-based codes, the CPT code set states that the following standards shall apply to time measurement: A unit of time is attained when the mid-point is passed. 201 Psychological and Neuropsychological Testing CPT® Codes Descriptions 2019 Psychological and Neuropsychological Testing CPT® Codes & Descriptions Aug 2, 2019 · Q: Suppose a patient comes in for psychological testing evaluation. Jun 5, 2023 · The Role of CPT Code 96131 CPT code 96131 describes “psychological testing evaluation services” conducted by a qualified healthcare professional. CPT 96130 refers to psychological testing evaluation services provided by a physician or other qualified healthcare professional. The CPT codes, 96138, 96139 and 96146 that fall under the CPT “Psychological and Neuropsychological Tests code range, 96105-96146, describe tests performed by technicians and computers. Learn how to bill psychological testing and evaluation services using the Current Procedural Terminology (CPT) codes. Providers should now use CPT code 96130 to bill for the first hour of psychological testing evaluation services and 96131 for each additional hour. This reimbursement policy applies to all health care services billed on CMS 1500 forms and, when Jun 10, 2025 · CPT 96137: What Medical Billers Need to Know in 2025 | Explore expert insights for mental health professionals on the Yung Sidekick blog. Mar 1, 2025 · 96130 (1 unit) and 96131 (1 unit) — (not to exceed one unit) or 96132 (1 unit) and 96133 (1 unit) — (not to exceed one unit) Two hours of test administration and scoring (30-minute codes): 96136 and/or 96138 — 1 unit (not to exceed two units) 96137 and/or 96139 — 1-3 units (not to exceed three units) Description of testing codes The Current Procedural Terminology (CPT ®) code 96137 as maintained by American Medical Association, is a medical procedural code under the range - Psychological and Neuropsychological Test Administration and Scoring. The first hour of evaluation is billed using 96132 and each additional hour needed to complete the service is billed with code 96133. A base code should only be submitted for the first unit of service, and only add-on codes should be used to capture subsequent units of service on the same or different days Bill separate interactive feedback session using an add-on code (either CPT® code 96131 or 96133) May 19, 2020 · I have a question in mental health billing 96130 & 96131. For example if testing evaluation services takes 3 hours to complete you would bill 96130 and 96131 with 2 units. In these situations, reimbursement for computer-based testing used as part of the evaluation is included in the evaluation and management CPT codes. It is important for healthcare providers to understand the specific requirements for using this code, including adequate session duration, proper documentation, and the types of services covered. These Frequently Asked Questions (FAQs) (PDF) provide clarification on Medicare billing and payment policy for these testing codes when performed by technicians, computers, physicians, clinical psychologists, independently practicing psychologists a Navigating the intricacies of medical billing can be daunting, but understanding specific CPT codes and their appropriate usage is essential to getting reimbursed for the full value of your services. To address these common concerns, we have compiled the top 10 most frequently asked questions from the Psychological Billing Oct 28, 2024 · Add-on codes (e. Clear documentation aligned with CPT guidelines helps avoid claim denials and maximizes reimbursement. This guide explains how they differ, when to use them, and how to bill accurately. Per the above chart, the claim should include one unit of each base code and subsequent units using add on codes. This ensures an accurate representation of the services provided while avoiding overcoding. g. Plus, discover how to avoid common billing errors when working with complex diagnoses. The Current Procedural Terminology (CPT ®) code 96132 as maintained by American Medical Association, is a medical procedural code under the range - Psychological and Neuropsychological Testing Evaluation Services. This code includes the administration and interpretation of standardized tests and measures, and the integration of the data into a diagnostic and treatment plan. The 96130 and 96131 CPT codes billing guide shows that therapists frequently forget to bill for additional evaluation hours beyond the first, losing $113-$175 per unit in reimbursement. CPT 96130 is reported for the first hour of testing. CPT code 96130 covers the first hour of professional psychological testing evaluation services by licensed psychologists or Oct 2, 2023 · Changes to authorization requirements Effective July 1, 2023, the authorization requirement for psychological testing codes will be updated and broken into two components: evaluation (96130, 96131, 96132, and 96133) and test administration and scoring (96136, 96137, 96138, and 96139): Evaluation codes are one-hour codes with a maximum of four ADDENDUM Provided below are three (3) examples of entire episodes of care for Psychological or Neuropsychological Assessment. Jun 16, 2025 · CPT Codes 96136 and 96137 are used for psychological or neuropsychological test administration and scoring. This guide outlines what 96130 covers The 96131 code specifically supports extended evaluation services beyond the first hour of testing. This code encompasses a comprehensive process that includes the integration of patient data, interpretation of standardized test results, and clinical data. Jan 3, 2025 · If evaluation time for 96130 exceeds one hour you may bill each additional hour by using CPT 96131. The service includes interactive feedback to the patient, family members, or Sep 10, 2024 · CMS released questions and answers on psychological and neuropsychological tests that are billed under the CPT code range 96101-96125. apa. When testing exceeds 60 minutes, report CPT 96131 for each additional hour of We would like to show you a description here but the site won’t allow us. This code encompasses a comprehensive process that includes the integration of patient data, interpretation of standardized test results, clinical decision-making, treatment planning, and the provision of interactive feedback to the patient, family members, or Unlock reimbursement for administering and evaluating psychological tests with CPT billing codes 96146, 96130 & 96131 Approximate reimbursement for 31 minutes of work: $104 We would like to show you a description here but the site won’t allow us. The Current Procedural Terminology (CPT ®) code 96130 as maintained by American Medical Association, is a medical procedural code under the range - Psychological and Neuropsychological Testing Evaluation Services. The psychiatric diagnostic interview examination (CPT codes 90791, 90792), psychological/ neuropsychological testing (CPT codes 96136-96146), and psychological/ neuropsychological evaluation services (CPT codes 96130-96133) must be distinct services if reported on the same date of service. The Current Procedural Terminology (CPT ®) code 96131 as maintained by American Medical Association, is a medical procedural code under the range - Psychological and Neuropsychological Testing Evaluation Services. We would like to show you a description here but the site won’t allow us. , CPT 96131 or 96133) should be utilized for additional services rendered during subsequent sessions that meet the 31-minute threshold or for any time reaching 91 minutes during the initial evaluation. Providers who are not credentialed to perform comprehensive neuropsychological testing may use computer-based testing. Mar 1, 2019 · I am just starting to bill for a psychologist and am confused about the codes. For psychological testing evaluation services, the first hour is reported using CPT code 96130 and each additional hour required to complete the psychological testing evaluation service is reported with the add-on code, 96131. They do testing 3 days for 2 hours a piece. This guide breaks down billing rules, time units, and compliance tips for these codes. Aug 19, 2024 · The Current Procedural Terminology (CPT) code range for Psychological and Neuropsychological Test Administration and Scoring 96136-96139 is a medical code set maintained by the American Medical Association. How do they report the dates? Do they report on 2/5: 96136, 96137 X3, 2/12 96137 x4, 2/19 96137 X4 or do they just report everything under 2/19: 96136, 96137 X 11 ve feedback to the patient, family members, or caregivers (when performed). CPT Code 96131: Jul 11, 2025 · CPT codes 96132 and 96133 are essential for billing neuropsychological testing evaluations. Now, there's eight! Learn how to navigate these new billing codes for mental health. Each example takes into consideration the most significant issues/problems reported by APA members since Background Psychological tests assess a range of mental abilities and attributes, including achievement and ability, personality, and neurological functioning. Providers should use the appropriate add-on codes for all additional units regardless of the date of service. Mar 28, 2023 · CPT Code 96130: CPT code 96130 is used for psychological testing evaluation services by a physician or other qualified healthcare professional. If testing evaluation services occur during multiple visits, providers should bill a single claim at the completion of the evaluation and test administration in its entirety. Jul 4, 2025 · Understand CPT Code 96130, its use in psychological testing, and get practical billing tips to ensure accurate documentation and reimbursement. Despite the importance of this topic, many professionals still have questions about the best practices for using CPT codes, billing units, and avoiding audits. I know that 96131 is the add on code and I was told by an insurance rep that they must be billed for the same date of service. Our behavioral health reimbursement policies may use Current Procedural Terminology (CPT®*), Centers for Medicare and Medicaid Services (CMS) or other procedure coding guidelines. If the interactive feedback session is held several days later, how would this be reported using CPT codes? Aug 19, 2024 · The Current Procedural Terminology (CPT) code range for Psychological and Neuropsychological Testing Evaluation Services 96130-96133 is a medical code set maintained by the American Medical Association. Neuropsychological Evaluation services include interpretation of test results and clinical data, integration of patient data, clinical decision making, treatment planning, report generation, and interactive feedback to the patient, family member(s) or caregiver(s). Apr 14, 2025 · The 96131 CPT code plays a vital role in the billing and documentation of psychological and neuropsychological testing services. Jan 14, 2020 · There were four CPT codes you could use for psychological testing. The provider interprets the test results and patient data, prepares a report, and begins treatment planning. * American Psychological Association website: 2019 Psychological and Neuropsychological Testing Billing and Coding Guide: https://www. Sep 29, 2025 · Many practitioners miss substantial revenue when billing for psychological testing. Nov 30, 2019 · Providers should now use CPT code 96130 to bill for the first hour of psychological testing evaluation services and 96131 for each additional hour. Psychological testing, including neuropsychological assessment, utilizes a set of standardized tests, whose validity and reliability have been established empirically. Enhance your therapy practice with AI. AGPCRNL-0082-19 96131; Psychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clin-ical decision making, treatment planning and report, and interactive feedback to the patient, family member(s) or caregiver(s), when The modifier serves to demonstrate that, following the completion of the health behavior assessment or re-assessment service, the psychologist then performed separate, distinct and non-overlapping test administration and scoring and/or testing evaluation services; however, choosing the appropriate modifier depends on how the assessment or reassessment service and the testing services were Knowing these codes is important for billing. For example, 96130 covers the initial hour at approximately $102, while 96131 applies to each additional hour at $78. It encompasses the interpretation of standardized tests, clinical decision-making, treatment planning, report generation, and interactive feedback provided to the patient or their family/caregivers. This reimbursement policy applies to all health care services billed on CMS 1500 forms and, when Mar 1, 2020 · Providers should now use CPT code 96130 to bill for the first hour of psychological testing evaluation services and 96131 for each additional hour. ID: 9177 Q: What are the supervision requirements for diagnostic psychological and neuropsychological tests? How psychologists can bill for assessments occurring over multiple days as well as billing for test administration by technicians and psychologists on the same day. A: Yes. This code encompasses the comprehensive process of administering standardized psychological tests, interpreting the results, and integrating clinical data to formulate a treatment plan. Find out the codes for psychologists and technicians, the hours of service, and the changes in 2018 and 2019. org Coverage provided by Amerigroup Inc. Actual reimbursement values may vary by demographic location and payer Using Add-on CPTs 96131 and 96133 for Additional Evaluation Time Add-on CPTs 96131 (primary code 96130) and 96133 (primary code 96132) can be added for each additional 31-minutes of evaluation after the first hour. Dec 23, 2024 · The 96131 CPT code is used for psychological or neuropsychological testing services that include a neurobehavioral status exam, with interpretation, clinical decision-making, and report preparation. cbev ytvtv yebuvo catq tlipwmj jmzkq tyurb mlleyz nekuovz nesy rggiv iemf xrmby ybiwk usn