2019 Updated CPT Codes for Therapists
This September, the American Medical Association announced the release of the 2019 Current Procedural Terminology (CPT®) code set. This update includes 335 code changes, however only a handful of these changes impact mental and behavioral health providers.
With these changes the current CPT codes for psychological testing (96101, 96102) and neuropsychological testing (96118, 96119) will no longer be in use starting in the new year, instead they will be replaced with new codes starting January 1, 2018.
The goal of the new coding structure is to allow providers to more accurately describe the work they are doing, especially when that work involves multiple hours of technical and professional services.
Testing services will have a new coding structure along with the new codes. Now, providers will bill with one code for the first hour of testing and include a different add-on code for each additional hour of testing services.
CPT Time Rules allow an additional unit of a time-based code to be reported as long as the midpoint of the stated amount of time is passed—at least an additional 31 minutes of work must be performed to bill an additional code.
What are the new codes?
- 96101 for psychological testing by a psychologist will now be replaced by 96130 and 96131 (for each additional hour listed separately in addition to code for primary procedure) for psychological testing evaluation services and 96136 and +96137 (for each additional hour) for test administration and scoring.
- 96102 for psychological testing by a technician will be replaced by 96130 and +96131 (for each additional hour) for psychological testing evaluation services and 96138 and 96139 (for each additional hour) for test administration and scoring.
- 96118 for neuropsychological testing by a psychologist will be replaced by 96132 and 96133 (for each additional hour) for neuropsychological testing evaluation services and 96136 and 96137 (for each additional hour) for test administration and scoring.
- 96119 for neuropsychological testing by a technician will now be replaced by 96132 and 96133 for neuropsychological testing evaluation services and 96138 and +96139 (for each additional hour) for test administration and scoring.
*old codes in italics
It is important to note that not all new code relate to old or deleted codes on a one-on-one basis and the above should only be used as a guide. You can access the official American Psychological Association’s crosswalk for the new psychological testing codes here and for the new neuropsychological codes here.
The New CPT Codes and Your Reimbursement Rates
After a long and confidential negotiation process, the APA has secured increased reimbursement rates for psychological testing. Reimbursements rates for psychological and neuropsychological testing services provided by psychologists and therapists, as well as neuropsychological testing where data is collected by a technician, is estimated to increase by 6%.
Heading into 2019
The new CPT codes bring about a lot of new changes. However, using the resources above, you’ll be well equipped to handle the new updates in 2019. Remember, these code changes go into effect on January 1, 2019–– that means for all services performed before the new year, even if you bill for them in 2019, you should use the old CPT codes.
TheraNest can also help ensure you’re ready to take on what’s coming next. We’ll have the new codes updated into our system on January 1, 2019—all you have to do is add the CPT codes, learn more here.
Don’t have TheraNest account? TheraNest has everything you need to build a better managed practice in 2019––from unlimited note templates for individual or group services to easy invoicing and billing––we’ve got you covered. Start your free 21 day trial of TheraNest today.