Psychological Testing Reimbursement Rates in 2024
Whether you’re a physician, psychologist, or technician, you need to understand the reimbursement rates for psychological or neuropsych testing in 2024.
Our guide to psych testing reimbursement rates in 2022 will teach you what Medicare pays qualified therapists, psychiatrists, and health care professionals for these CPT codes.
Psych Testing Reimbursement Rates 2022
Please see our table below for reimbursement rate data per CPT code in 2024, 2023, 2022, 2021, and 2020.
| CPT Code | Description | Medicare Reimbursement Rate 2022 | Medicare Reimbursement Rate 2023 | Medicare Reimbursement Rates 2024 |
|---|---|---|---|---|
| 90791 | Psychological Diagnostic Evaluation | $195.46 | $174.86 | $169.29 |
| 90792 | Psychological Diagnostic Evaluation with Medication Management | $218.90 | $196.55 | $190.57 |
| 90832 | Individual Psychotherapy, 30 Minutes | $85.07 | $75.57 | $76.95 |
| 90833 | Individual Psychotherapy with Evaluation and Management Services, 30 minutes | $77.88 | $69.47 | $70.73 |
| 90834 | Individual Psychotherapy, 45 Minutes | $112.29 | $99.97 | $101.51 |
| 90836 | Individual Psychotherapy with Evaluation and Management Services, 45 minutes | $98.30 | $88.11 | $89.39 |
| 90837 | Individual Psychotherapy, 60 Minutes | $164.84 | $147.07 | $149.64 |
| 90838 | Individual Psychotherapy with Evaluation and Management Services, 60 minutes | $129.30 | $116.57 | $118.53 |
| 90839 | Individual Crisis Psychotherapy initial 60 min | $157.66 | $141.31 | $144.07 |
| 90840 | Individual Crisis Psychotherapy initial 60 min, each additional 30 min | $78.64 | $70.15 | $71.38 |
| 99201 | Evaluation and Management Services, Outpatient, New Patient | Not covered | Not covered | Not covered |
| 99202 | Evaluation and Management Services, Outpatient, New Patient | $80.91 | $72.86 | $71.06 |
| 99203 | Evaluation and Management Services, Outpatient, New Patient | $124.39 | $112.84 | $109.69 |
| 99204 | Evaluation and Management Services, Outpatient, New Patient | $185.26 | $167.40 | $164.38 |
| 99205 | Evaluation and Management Services, Outpatient, New Patient | $244.99 | $220.95 | $216.77 |
| 99211 | Evaluation and Management Services, Outpatient, Established Patient | $25.71 | $23.38 | $22.92 |
| 99212 | Evaluation and Management Services, Outpatient, Established Patient | $62.76 | $56.93 | $55.67 |
| 99213 | Evaluation and Management Services, Outpatient, Established Patient | $100.57 | $90.82 | $89.39 |
| 99214 | Evaluation and Management Services, Outpatient, Established Patient | $141.78 | $128.43 | $126.07 |
| 99215 | Evaluation and Management Services, Outpatient, Established Patient | $200.00 | $179.94 | $177.47 |
| 99354 | Prolonged Services | $140.26 | Not covered | Not covered |
| 99355 | Prolong Services with E/M | $101.32 | Not covered | Not covered |
| 90846 | Family psychotherapy without patient, 50 minutes | $107.37 | $95.56 | $95.94 |
| 90847 | Family psychotherapy with patient, 50 minutes | $111.15 | $99.63 | $100.53 |
| 96105 | Assessment of aphasia and cognitive performance | $109.26 | $98.27 | $94.30 |
| 96112 | Developmental testing administration by a physician or qualified health care professional, 1st hr | $141.02 | $126.74 | $121.81 |
| 96113 | Developmental testing administration by a physician or qualified health care professional, each additional hour | $66.54 | $59.98 | $58.94 |
| 96116 | Neurobehavioral status exam performed by a physician or qualified health professional, first hour | $104.73 | $93.19 | $90.37 |
| 96121 | Neurobehavioral status exam performed by a physician or qualified health professional, additional hour | $87.34 | $75.91 | $73.67 |
| 96125 | Standardized cognitive performance test administered by health care professional | $115.69 | $103.36 | $100.53 |
| 96127 | Brief emotional and behavioral assessment | $5.29 | $4.74 | $4.58 |
| 96130 | Psychological testing and evaluation by a physician or qualified health care professional, first hour | $132.70 | $120.30 | $117.88 |
| 96131 | Psychological testing and evaluation by a physician or qualified health care professional, each additional hour | $98.68 | $86.75 | $84.15 |
| 96132 | Neuropsychological testing and evaluation by a physician or qualified health care professional, first hour | $144.80 | $130.13 | $126.07 |
| 96133 | Neuropsychological testing and evaluation by a physician or qualified health care professional, each additional hour | $112.29 | $98.95 | $95.61 |
| 96136 | Neuropsychological or psychological test administration and scoring by a physician or qualified health care professional, first hour | $49.15 | $42.70 | $40.93 |
| 96137 | Neuropsychological or psychological test administration and scoring by a physician or qualified health care professional, each additional hour | $44.24 | $39.31 | $37.00 |
| 96138 | Neuropsychological or psychological test administration and scoring by a technician, first hour | $38.56 | $34.23 | $33.73 |
| 96139 | Neuropsychological or psychological test administration and scoring by a technician, each additional hour | $$39.32 | $35.24 | $34.71 |
(Source)
Psychological and Neuropsychological Services Coding Guidelines
Each psych testing CPT code is different. Maker sure to review current Medicare service provider guidelines to ensure you’re exceeding expectations on behalf of yourself and your clients.
Ensure direct clinical observation (CPT Code 96116).
Review their records (CPT Code 96118).
Make sure to complete forms and questionnaires associated with their files (not billable with Medicare in 2022).
Select, administer, and interpret neuropsych testing directly by a neuropsychologist (CPT Code 96118) or a technician under supervision (96119), or perhaps even by a computerized test (CPT Code 96120).
Integrate the test findings across all aforementioned data points by the neuropsychologist (CPT Code 96118).
Formulate differential diagnosis, including diagnostic conclusions and treatment recommendations (again 96118).
Provide feedback directly related to the testing procedures, results, implications, and conclusions including treatment recommendations and follow up as needed.
Create a written report for the patient and referring healthcare professional.
Source: Medicare Coding Guidelines
See the above link for more information about exclusions including testing for Alzheimers disease.
No comments yet.