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MEDICAID INFORMATION RELEASE MA06-10

posted on March 02, 2009 12:18

April 7, 2006

MEDICAID INFORMATION RELEASE MA06-10

TO: Psychosocial Rehabilitation Agencies, Mental Health Clinics, Developmental Disability Agencies, Schools

FROM: Leslie Clement, Deputy Administrator

SUBJECT: NOTICE OF CHANGE IN CODES FOR PSYCHOLOGICAL TESTING

Effective for dates of service beginning January 1, 2006, the CPT code 96100 for psychological testing is invalid and has been changed. The new Medicaid reimbursable codes are 96101, 96102 and 96103. Please see the Table 1 below for the CPT Codes and CPT Service descriptions.

Table 1. CPT Codes and CPT Service Descriptions to be Used for Psychological Testing

CPT Code	Description
96101	Psychological testing (includes psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, e.g., MMPI, Rorschach, WAIS), per hour of the psychologist’s or physician’s time, both face-to-face time with the patient and time interpreting test results and preparing the report.
96102	Psychological testing (includes psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, e.g., MMPI, WAIS),with qualified healthcare professional interpretation and report, administered by technician, per hour of technician time, face-to-face.
96103	Psychological testing (includes psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, e.g., MMPI), administered by a computer, with qualified healthcare professional interpretation and report.

Providers should resubmit claims using the new codes for dates of service since January 1, 2006, that were previously denied due to explanation 223 on the Explanation Of Benefits (EOB) form: “HCPC/CPT code invalid for dates of service”.

Providers must strictly adhere to requirements described in the provider type’s applicable section of rule in the provision of psychological testing services. To determine what practitioners are allowed to perform psychological testing, including administration, scoring, interpretation and report writing please refer to Table 2.

Table 2. Types of Providers and the Practitioners Who are Qualified to Perform Psychological Testing

Provider Types	Practitioners Who are Qualified to Perform Psychological Testing (including administration, scoring, interpreting test results, report writing)
Mental Health Clinics Psychosocial Rehabilitation Agencies Developmental Disability Agencies	Licensed Psychologists and Psychologist Extenders, registered with the Bureau of Occupational Licenses The following practitioners who have documented evidence of education or training qualifying him to administer, score, interpret, and report findings for the psychological tests he will be performing: Licensed Psychiatrists, Licensed Physicians, Physician Assistants, Nurse Practitioners, Licensed Clinical Social Workers, Licensed Clinical Professional Counselors, Licensed Marriage and Family Therapists, Certified Psychiatric Nurses(RN),Licensed Professional Counselors, Licensed Masters Social Workers
Schools	Licensed Psychiatrists, Licensed Physicians, Licensed Psychologists, Psychologist Extenders, registered with the Bureau of Occupational Licenses, Certified School Psychologists

If you have any questions concerning the information contained in this release, please contact Pat Guidry, Behavioral Health Policy Specialist, at (208) 364-1844.

Thank you for your continued participation in the Idaho Medicaid Program.

LMC/pg/sw

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