Up-to-Code: Testing code changes on the horizon

Preparing psychologists for upcoming billing code changes taking effect Jan. 1, 2019.

A new coding system for Psychological and Neuropsychological Testing services is on the horizon. Through a multifacetted process involving the American Medical Association (AMA) and the Centers for Medicare and Medicaid Services (CMS), new Current Procedural Terminology® (CPT) codes, descriptors and billing processes will be revealed this summer, and APA and the Practice Organization are ready to prepare the profession to handle these changes before they take effect on Jan. 1, 2019.

Due to strict confidentiality obligations, the APA Practice Organization is prohibited from premature release of the coding changes. However, as indicated in the Summary of Panel Actions from September/October 2016 (PDF, 145KB; see page 9) and June 2017 (PDF, 111KB; see page 5), the AMA CPT Editorial Panel accepted revisions to the testing code set “to differentiate technician administration of psychological testing and neuropsychological testing from physician/psychologist administration and assessment of testing.”

While these documents do not provide detailed information, they do serve as public notification of impending revisions to the family of Psychological and Neuropsychological testing codes (CPT codes 96101-96103, 96118-96120). Specific information regarding new code numbers and descriptors will be disclosed in September by the AMA CPT Panel’s publication of the 2019 CPT manual.

On or around July 1, CMS will provide additional insight regarding implementation of the updated Psychological and Neuropsychological Testing code set in the Medicare physician fee schedule Proposed Rule. It is important to note that changes to individual or families of codes are not isolated to Medicare. Private insurance companies are also obligated to use updated codes and coding systems. Therefore, whether you participate in Medicare or not, the information published in the Medicare proposed and final rules will impact you and the services you bill.

After publishing the proposed rule, the Practice Organization will submit a comment letter to CMS addressing the agency’s proposed changes to the testing codes. Individual practicing psychologists, like you, may also need to provide feedback on the proposed rule.

In November, CMS will release the final 2019 reimbursement values in Medicare Physician Fee Schedule final rule.