by Government Relations Staff
October 25, 2007 — Two changes in the Current Procedural Terminology (CPT®) book for 2008 may help psychologists bill properly for the services they provide effective January 1. CPT 2008 incorporates clarifying language that describes when to use the codes for psychological and neuropsychological testing. The book also includes new CPT codes for team conferences involving nonphysicians.
Earlier this year, the APA Practice Organization (APAPO) asked the CPT Editorial Panel to add clarifying language to the CPT codes for psychological and neuropsychological testing. APAPO made this request to resolve confusion among billers, compliance officers and insurers about appropriate use of the 96101 and 96118 codes for psychological (96101) and neuropsychological (96118) testing by the psychologist, with interpretation and report.
New language in CPT 2008 clarifies that the 96101 and 96118 codes also can be billed for time the psychologist spends integrating other sources of clinical data, including previously interpreted results and information from tests that were administered by a technician or computer, into a report. In asking for the clarification, APAPO asserted that integration of test results and other sources of clinical data is a different service than administering, interpreting and reporting on individual tests.
Importantly, this clarification does not represent a Medicare or other policy change nor does it change the way that these testing codes are intended to be used. The new language does not change any existing Medicare billing rules such as the need to append modifier 59 to the technician and computer-based testing codes when they are billed with the professional code for the same patient on the same date of service.
The 2008 coding book also makes it clear that the time a psychologist spends interpreting and reporting on each individual test administered by a technician or computer is still paid for under the relevant technician- or computer-administration codes (96102/96119, and/or 96103/96120).
Beginning in January 2008, psychologists may bill two new codes for team conference services when practitioners are involved in meetings of at least 30 minutes between interdisciplinary professionals from at least three disciplines to assess a patient’s care plan and progress. The team conference codes, 99366 and 99368, are specifically intended for use by nonphysician practitioners. In the past, similar CPT codes were available exclusively to physicians.
As one example, a psychologist, occupational therapist and neurologist may meet for 45 minutes to discuss health and behavior interventions for a hospitalized Medicare beneficiary who is recovering from a stroke. The psychologist and the occupational therapist can each bill the relevant team conference code: 99366 if the patient is present; 99368 if the patient is not present.
In another change, the CPT Editorial Panel approved a new code for standardized cognitive performance testing for use by occupational and physical therapists. The code’s descriptor specifically states that it is not for use by psychologists, who will continue to use the codes for psychological and neuropsychological testing.
CPT 2008 books can be ordered from the AMA websiteopens in new window or by calling 800-621-8335.
CPT copyright 2006 American Medical Association. All rights reserved.