MyMind Lab provides you with an objective, precise, and a core set of neurocognitive and mental health assessments that help support the evaluation and management of many neuro and psychological conditions.
Generally, there may be three possible procedure coding events… (1) A testing, interpretation, and reporting event, (2) The time a clinician takes integrating the test results into other sources of clinical data, and (3) Billing for psychological, behavioral, mental health and other important clinical rating tests.
Psychological and Psychiatric *ESTIMATED NATIONAL
96101 Psychological testing (includes psych assessment of emotionality, intellectual abilities, *$80.00
cognition, personality and psychopathology, e.g., MMPI, Rorschach, WAIS, BMHE),
per hour of the qualified healthcare professional time, both face-to-face time administering
Min of 31 minutes of face to face time with the patient.
96102 Psychological testing (includes psych assessment of emotionality, intellectual abilities, cognition, *$64.00
personality and psychopathology. e.g., MMPI, BMHE, and WAISI), with qualified health care
professional interpretation and report, administered by technician, per hour of technician time,
96103 Psychological testing (includes psych assessment of emotionality, intellectual abilities, personality *$30.00
and psychopathology, e.g., MMPI, BMHE), administered by a computer, with qualified health care
professional interpretation and report.
CMS (Recovery Audit Program) and other payers have active and ongoing audit programs to recover fraudulent claims. Clients have expressed the following tips to help a practice be prepared for an audit.
KEY ADVANTAGE: The MyMind Lab Testing Portal Auto‐Generates the patient information, date and time of the assessment and time to complete the assessment.
Technical: Label whether Tech admin or Computer admin, Number of Tests.
Professional: Label Activities: Testing by Professional, Interpretation, Report, or Integration of findings which may include history, prior records, interview(s), and compilation of tests.
Denial of Coverage: Most payers consider computerized psychological assessment procedures medically necessary because the assessment procedure aids in the assessment of psychological impairment due to medical or psychiatric conditions. Psychological testing such as the BMHE help clinicians better understand the nature of their patient’s illness, in making recommendations regarding coping with and compensating for their psychological difficulties, and encourages treatment adherence. If for some reason the carrier or plan denies coverage it is important to EDUCATE and INFORM the carrier or plan’s personnel about the importance of covering the procedure.
About 96118 and 96101… These Codes are reported for psychological and neuropsychological test administration by the qualified health care professional with subsequent interpretation and report. It is also reported for the integration of information obtained from other sources which is then incorporated in a more comprehensive interpretation of the meaning the tests results in the context of all testing and assessments. The administration of the tests is completed for the purposes of a physical health evaluation and management.
About 96103 and 96120… These Codes are reported for the computer‐administrated psychological and neuropsychological testing, with subsequent interpretation and report of the specific tests by a qualified health care professional. This should be reserved for situations where the computerized testing is unassisted by a provider or technician other than the installation of programs/test and checking to be sure that the patient is able to complete the tests. If greater levels of interaction are required, though the test may be computerized administer, then the appropriate physician/psychologist (96101/96118) or technician code (96102/96119) should be used.
*Medical Necessity can vary by Payer. MyMind Lab / Tests (e.g. Neuro-Cognitive and psychological)
Clinicians should consult with their office’s coding and billing staff to determine the combination of codes that will work best for screening and providing mental health services. It is also suggested that the billing office reach out to the health plans the provider participates in to inquire about whether they provide payment for mental health screening and, if so, to clarify with the health plans what codes, combination of codes should be used. The information provided in this section can be shared with health plans to see if they accept the codes in this guide.
Disclaimer: The information provided on this website was obtained from third‐party sources and is subject to change without notice as a result of changes in reimbursement laws, regulations, rules, and policies.
All content on this page is informational only, general in nature, and does not cover all situations or all payers’ rules and policies. This content is not intended to instruct medical providers on how to use or bill for health care procedures, including new technologies outside of Medicare national guidelines. A determination of medical necessity is a prerequisite that MyMind Lab assumes will have been made prior to assigning codes or requesting payments.
Medical providers should consult with appropriate payers, including Medicare fiscal intermediaries and carriers, for specific information on proper coding, billing, and payment levels for healthcare procedures. This information represents no promise or guarantee by MyMind Lab concerning coverage, coding, billing, and payment levels. MyMind Lab specifically disclaims liability or responsibility for the results or consequences of any actions taken in reliance on this information.