558. Why Your Claims Are Being Denied: Common Coding Errors

Dr. Jeremy SharpPodcast Leave a Comment

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In this episode, I break down the essential components of the “core stack” for psychological and neuropsychological testing billing. Many clinicians leave significant revenue on the table by skipping the diagnostic interview code or miscategorizing professional integration time as simple test administration. I explain the critical differences between the 60-minute professional work codes and the 30-minute administration codes, while highlighting the “half plus one” rule that can legitimately maximize your reimbursement. We also touch on specialized codes for developmental and neurobehavioral screens and the absolute necessity of maintaining an audit-ready log to protect your practice.

Main Topics Covered

  • 00:01: Introduction to the core billing stack: 90791, 96132, and 96133
  • 02:08: Why you must never skip the 90791 diagnostic interview code
  • 03:25: Understanding 96132 and 96133 as 60-minute professional work units
  • 05:20: Differentiating between psychological (96130) and neuropsychological (96132) evaluation codes
  • 07:15: Deep dive into test administration and scoring codes 96136 and 96137
  • 08:55: Navigating daily unit caps and insurance panel “soft caps”
  • 10:45: Utilizing obscure codes for neurobehavioral and developmental testing
  • 12:45: The “half plus one” timing strategy for maximizing billed units
  • 15:20: Creating audit-ready documentation and the importance of precise time logs

Cool Things Mentioned

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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