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 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