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There are so many documents and guidelines out there on billing insurance for testing. So why is it so hard? Variations among insurance panels are a big part of the equation. In spite of relatively clear “rules” about CPT codes and how to bill our services, many panels devise their own procedures for insurance billing, causing us a big headache. Today, I attempt to break down insurance billing for both psychological testing and neuropsychological testing. Here are a few things that I cover:
- Basics of insurance billing: CPT codes & units
- Psychological testing vs. Neuropsychological testing
- Navigating limitations on hours
- Medical necessity
- Appeals and resubmissions
- Weird situations that may come up
Cool Things Mentioned
- Dr. Antonio (Tony) Puente’s work
- Dr. Neil Pliskin’s work
- Testing Psychologist episode on medical necessity
- APA’s resource page on billing for testing
- Testing Psychologist episode on TextExpander
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About Dr. Jeremy Sharp
I’m a licensed psychologist and Clinical Director at the Colorado Center for Assessment & Counseling, a private practice that I founded in 2009 and grew to include 12 licensed clinicians, three clinicians in training, and a full administrative staff. I earned my undergraduate degree in Experimental Psychology from the University of South Carolina before getting my Master’s and PhD in Counseling Psychology from Colorado State University. These days, I specialize in psychological and neuropsychological evaluation with kids and adolescents.
As the host of the Testing Psychologist Podcast, I provide private practice consulting for psychologists and other mental health professionals who want to start or grow psychological testing services in their practices. I live in Fort Collins, Colorado with my wife (also a therapist) and two young kids.
Ready to grow your testing services? Click below to schedule a complimentary 30-minute pre-consulting call!
Comments 4
I found your podcast on Billing Insurance for Psychological and Neuropsychological Testing extremely helpful. Not sure when this first aired, but I noticed your frustration with Optum. I’m having the same frustration. Since this podcast aired, have you any additional information to share in getting them to pay for testing? I’m finding they are only paying for one unit (base code) and not the add-on code.
Author
I just found this comment. I imagine that you’ve figured it out by now, but Optum continues to give us trouble with billing. They require all testing appointments to be billed on the same claim for handling, yet they also separate the claims during processing. They’re next on the chopping block in terms of dropping insurance panels for testing.
This is so helpful! Thank you for this gift.
Author
Sure! Hope it’s helpful.