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In this episode, I break down what I believe are the most important business trends shaping assessment practices in 2026. Rather than focusing on vague predictions or generic AI hype, I zero in on the operational, regulatory, and payer-driven forces that are already creating friction for assessment-focused psychologists. My central argument is that 2026 will not be a “breakthrough” year. It will be a friction year, where practices succeed or struggle based on how clearly they can justify, document, and defend their work. I walk through how insurance pressures, prior authorization, AI governance, workforce scarcity, and shifting expectations around comprehensive batteries are converging, and what practical steps assessment clinicians can take now to stay viable, ethical, and sustainable.
Main Topics Discussed
- Why 2026 is a “friction year,” not a breakthrough year (00:01)
- The unifying trend: auditability, justification, and traceability across systems (02:23)
- Efficiency adjustments and why integration work matters more than test administration (03:00)
- Auditing CPT code mix and aligning documentation with payer values (04:45)
- Prior authorization becomes more structured—and less forgiving (05:30)
- Building repeatable medical necessity language and pre-auth workflows (07:07)
- Payers tightening testing policies and eliminating “neutral” practice models (08:30)
- Choosing explicitly between insurance-first, hybrid, or cash-pay models (09:28)
- AI’s shift from convenience tool to governance and risk issue (10:30)
- Clinicians moving from “writer” to “editor” roles with AI-assisted workflows (11:38)
- State-level healthcare AI laws and the need for internal AI policies (12:30)
- Validity and defensibility becoming built-in, not optional (13:45)
- Rethinking over-testing and defining a minimum defensible data set (14:01)
- Hybrid assessment models and redesigning physical office space (15:00)
- Workforce scarcity and choosing between boutique vs scalable models (17:30)
- The controversial take: rethinking the default comprehensive battery (18:53)
- Why auditability—not tools—is the real work of 2026 (20:00)
Cool Things Mentioned
- The Testing Psychologist mastermind groups and business consulting
- Reverb: the premier AI-powered report-writing platform for testing psychologists
- CMS Prior Authorization and Interoperability Rule overview: https://www.cms.gov/priorities/key-initiatives/burden-reduction/prior-authorization
- APA guidance on medical necessity and documentation: https://www.apaservices.org/practice/reimbursement/health-plans/medical-necessity
- APA resources on AI and ethics in practice: https://www.apa.org/monitor/2023/07/ai-psychology
- Episode on medical necessity: https://thetestingpsychologist.com/ttp-49-medical-necessity-pre-authorization-testing-services/
Featured Resources
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The Testing Psychologist podcast is approved for CEU’s!
I’ve partnered with At Health to offer CE credits for podcast episodes! Visit this link to access current and past episodes available for CE credit. You can use code “TTP10” for a discount on ALL the course credits you purchase from At Health!
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 have grown to over 20 clinicians. 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.
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