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Proper billing for psych testing services helps ensure accurate payment

Bill all codes together on last date of service

Psychiatrists or psychologists providing psychological testing services (Testing Evaluation Services 96160-96133 and/or Test Administration and Scoring Services 96136-96139) know that these most often occur across multiple dates of service.

When psych testing services are spread out over multiple days, we recommend that you bill all codes together on the last date of service, when the evaluation process is completed. 

  • Submit base codes (96130, 96132, 96136, 96138) only for the first unit of service of the evaluation process.
  • Submit add-on codes (+96131, +96133, +96137, +96139) to bill for services provided during subsequent units. 

CPT® code 96146 represents a single automated or neuropsychological instrument that is administered via electronic platform (e.g., computer); bill that for a single test administered via electronic platform. When you administer two or more tests, use Test Administration and Scoring Services 96136-96139 codes.

Magellan requires providers to complete psych testing cases within six months. If you are billing sessions prior to the completion of the entire evaluation process, the APA recommends submitting a note on the date of each service that indicates:

  1. Number of hours of service provided and billed on that day “with evaluation ongoing and report to follow.”
  2. Final report documentation that includes all dates corresponding to services provided.

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Welcome to Provider Focus, our award-winning e-newsletter for network providers! Here you’ll find articles and information to keep you up-to-date on news and topics relevant to serving Magellan members, including a section for regional- and plan-specific news. Check back as a new issue is released each quarter.

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