Many insurance companies recognize the validity of Continuous Performance Tests (CPT) in clarifying the diagnosis of ADHD. Some insurance companies require any psychological testing to be pre-approved and it may be necessary to provide documentation regarding the reasons for the testing. If testing using IVA-2 is questioned, IVA-2 Reliability and Validity studies are included in the IVA+Plus Interpretation Manual, and permission is granted to registered users to copy these studies for the purpose of obtaining reimbursement for services rendered.
Effective January 1st, 2006, CPT codes for billing have changed. Billing procedures now require different codes depending upon who performed the testing – the clinician, a technician, or solely computer based testing.
Further information may be found at the apapractice.org.
For the complete Billing Suggestions PDF, please CLICK HERE.
|Code||Description, Definition, Typical Diagnoses|
|96101||Psychological testing, interpretation and reporting per hour by a
psychologist. Billed as 1 unit per hour. Includes test administration, interpretation,
and report writing. Typically billed 3-4 units and up to 6 units is
|96102||Psychological testing per hour by a technician|
|96103||Psychological testing by a computer, including time for the
psychologist’s interpretation and reporting
|96118||Neuropsychological Test, Interpretation and Reporting per hour by a
psychologist Billed as 1 unit per hour. Includes I.Q., memory, attention, problem
solving, processing speed, mental flexibility and other
neuropsychological tests. Typically billed as 6-7 units.
|96119||Neuropsychological testing per hour by a Technician|
|96120||Neuropsychological testing by a computer, including time for the
psychologist’s interpretation and reporting
Generally speaking, clinicians can bill 96101 if they are in the room during the administration and actively observing the client. During this testing process it is recommended that clinicians record a client’s test behavior using the Behavioral Observation form included with IVA-2 during the test which they can interpret using their clinical judgement. They can also have the client complete both background and self-report forms about their history experience which are two separate instruments. The “Print Questionnaires” button on IVA-2 test administration screen is located at the bottom
of this screen on the left hand side and will display a PDF of all of the IVA-2 questionnaires for printing. The IVA-2 and/or other rating scale data can then also be entered either automatically via a web download (if it is completed online) or manually from IVA-2 ADHD rating scale forms or by manually entering the T or symptom scores from other paper and pencil ADHD rating scales. This test administration service is typically billed as one unit of 96101 when the clinician is in the room during the IVA-2 test.
Once testing is completed the health care professional will then need to review the test data which can include the analysis of test scores, the IVA-2 test report interpretations, and/or the completion of the IVA-2 Clinical Report which includes a review of relevant and important clinical data generally needed for a comprehensive ADHD diagnosis clinical decision. This process of report interpretation and
preparation will generally take at least one unit of 96101 and in some cases, when additional test data is collected such as the MeSA-AE or other tests, could take a total of two to four units of 96101.
Typically the 96103 code would be used to bill one unit if the clinician is not in the room and has a testing technician administer the test. It is NOT recommended that the client take the test unsupervised as it would then not be possible for the clinician to fully validate that the test was completed. For the IVA-2 test to be considered valid, it is necessary that the client was determined via
the clinician’s judgement that he or she made their best effort and fully comprehended the test task. Since the report and test analysis is a separate clinical step, then additional units of 96101 can then be appropriately billed in addition to the 96103 code..
Clinicians will need to keep in mind that the approval and payment for any testing charges will vary by insurance company and also by their state. They may also need pre-approval from some insurance companies in order to be compensated for testing fees. It is generally recommended that the IVA-2 be administered as part of a comprehensive clinical evaluation which addresses relevant issues and this process typically will include a clinical intake, as well as, ADHD rating scales and additional appropriate psychological tests. Thus, the IVA-2 is best used only within the framework of this type of comprehensive clinical evaluation. The purpose of the IVA-2 is to help guide clinicians in their clinical decision process relying only on the IVA-2 as one component of the numerous important diagnostic factors that clinicians will use in making their determination of their diagnosis for each client.