Get Ready to Use New Mental Health CPT Codes in 2019

CPT updates include 4 new categories of codes

You can expect big changes to mental and behavior health CPT codes in 2019. Get up to speed on the all the coding updates so you can avoid denials and get the reimbursement you deserve.

Crucial: Make sure you’re aware of and understand the new codes for psychological testing, developmental testing, behavior identification assessment, and adaptive behavior treatment, advises coding expert Dorothy Steed in her AudioEducator webinar, 2019 CPT® Updates for Mental and Behavior Health. In her instruction session, she also walks attendees through the documentation changes for 2019.

Codes Specify Pro’s or Tech’s Work

The good news is that 2019 mental health CPT codes changes could make your life a little easier.

The APA Practice Organization, which helped to develop the 2019 CPT codes, believes that the code changes should yield some significant advantages for mental health professionals, such as:

  • A clear differentiation between the professional and technical services (for instance, technical test administration and scoring services versus professional evaluation services).
  • A clear differentiation between work performed by a psychologist or neurologist who personally administers tests and a test administered by a technician.
  • A modernization of the code set to distinguish stand-alone, single-computer screening tests from a battery of psychological or neuropsychological tests.

What’s changed? The Centers for Medicare & Medicaid Services (CMS) deleted the CPT codes for reporting psychological and neuropsychological testing services. The deleted codes include 96101, 96102, 96103, 96118, 96119, and 96120.

Deleting these old CPT codes should help to clear up confusion over how to bill across multiple days of service and how to code the “Interactive feedback,” the APA said. The code changes should also help psychologists get compensation for non-face-to-face work by a professional and/or technician.

Take a Peek at 9 New Codes

CMS is replacing the deleted codes with a more comprehensive set of codes. Here’s just a sampling of the added codes for 2019:

  • 96112/96113 — Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report…
  • 96130/96131 — Psychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, family member(s) or caregiver(s), when performed…
  • 96132/96133 — Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, family member(s) or caregiver(s), when performed…
  • 96136/96137 — Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method…
  • 96138/96139 — Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method…
  • 96146 — Psychological or neuropsychological test administration, with single automated, standardized instrument via electronic platform, with automated result only
  • 97152 — Behavior identification-supporting assessment, administered by one technician under the direction of a physician or other qualified health care professional, face-to-face with the patient, each 15 minutes
  • 97153 — Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes
  • 97156 — Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes

According to the National Association of Healthcare Revenue Integrity (NAHRI), these more specific codes for psychological and neuropsychological testing fall into four subsections:

  1. Automated testing result
  2. Neurobehavioral status examinations
  3. Test administration and scoring
  4. Testing evaluations services

There are also new and revised CPT codes for central nervous system assessments, NAHRI noted.

Wait: Don’t Start Until Jan. 1

The new CPT codes will be effective on January 1, 2019. Until then, use the current 2018 CPT codes.

There are 335 code changes in the 2019 CPT edition, according to the American Medical Association (AMA), so be sure to check all the codes you use to look for any deletions, additions, or revisions

Bottom line: Study the added mental and behavior health CPT codes carefully, and ensure your documentation supports the new reporting guidelines, stresses coding expert Dorothy Steed. The new CPT codes will no doubt completely change the way you report your mental and behavior health services—and she’ll show you how to avoid the pitfalls in her 2019 CPT® Updates for Mental and Behavior Health webinar.

To join the conference or see a replay, order a DVD or transcript, or read more

4 thoughts on “Get Ready to Use New Mental Health CPT Codes in 2019”

  1. krissy says:

    CPT code 96102 was billed out on 01-14-19 but the dos was 11-12-18. do I still use this code or the new code since it doesn’t start until jan2019?

  2. Monica R McLendon says:

    “For dates of service before Jan. 1, 2019: Providers can bill with the old codes, and the claim
    will pay. Timely filing limits apply.”

  3. Monica R McLendon says:
  4. Anita says:

    Anthem Blue Cross is denying CPT codes 96136 and 96137 as invalid billed in 1/19?

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