Billing & Coding Reference
CPT codes for neuropsychological evaluation — time rules, common payer notes, and documentation requirements.
Disclaimer: This reference is for educational purposes only. Billing rules change frequently. Always verify current requirements with your payer contracts, the AMA CPT manual, and a qualified billing specialist. This page does not constitute billing or legal advice.
Core Neuropsychological Testing CPT Codes
| CPT Code | Description | Time Unit | Who Performs | Notes |
|---|---|---|---|---|
| 96132 | 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 | First hour | QHP (psychologist) | This is the “professional” code for the psychologist’s interpretation and report writing time. Billed once per evaluation day for the first hour of professional time. |
| 96133 | Neuropsychological testing evaluation services — each additional hour | Each additional 30 min | QHP (psychologist) | Add-on code to 96132. Billed for each additional 30 minutes of professional time beyond the first hour. Time-based — must document total time. |
| 96136 | Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; first 30 minutes | First 30 min | QHP (psychologist) | Used when the psychologist personally administers and scores tests. Requires 2+ tests. |
| 96137 | Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional — each additional 30 minutes | Each additional 30 min | QHP (psychologist) | Add-on to 96136 for additional 30-minute increments of QHP-administered testing. |
| 96138 | Psychological or neuropsychological test administration and scoring by technician, first 30 minutes | First 30 min | Technician (psychometrist) | Used when a technician (psychometrist) administers and scores tests under QHP supervision. |
| 96139 | Psychological or neuropsychological test administration and scoring by technician — each additional 30 minutes | Each additional 30 min | Technician (psychometrist) | Add-on to 96138 for additional technician testing time. |
Time-Based Billing Rules
Codes 96132, 96133, 96136, 96137, 96138, and 96139 are all time-based. Key rules:
- Document total time: Your notes must document the total time spent on each activity (testing, interpretation, report writing, feedback).
- The 8-minute rule: For add-on codes, you must spend at least 8 minutes (half of 15) to bill an additional unit. The standard threshold for time-based codes is that you must exceed the midpoint of the time interval.
- Separate days: Testing and interpretation/report writing may occur on different days. Bill 96132/96133 on the day of interpretation/report, and 96136–96139 on the day(s) of testing.
- Feedback session: Feedback to patient/family is included in 96132 when performed. It does not generate a separate code unless it is a standalone psychotherapy session.
Common Payer-Specific Notes
| Payer Type | Common Requirements |
|---|---|
| Medicare | Requires medical necessity documentation. Prior authorization may be required. LCD (Local Coverage Determination) varies by MAC (Medicare Administrative Contractor). Psychologists bill under their NPI. |
| Medicaid | Highly variable by state. Many state Medicaid programs require prior authorization for neuropsychological testing. Check your state’s fee schedule. |
| Commercial insurance | Prior authorization almost always required. Many payers limit total hours per evaluation. Some require specific diagnoses (e.g., TBI, dementia, ADHD) to authorize testing. |
| Self-pay | No prior authorization needed. Set your fee schedule based on time, complexity, and local market rates. Provide a superbill for patients to submit for out-of-network reimbursement. |
Documentation Tips
- Document the referral question and medical necessity clearly in the intake note
- Record start and stop times for each testing session
- Document total time for interpretation, integration, and report writing separately from testing time
- Note which tests were administered by the QHP vs. technician
- Include the feedback session date and duration in your records
- Keep prior authorization numbers and approval dates in the chart
Tip: The APA Practice Organization publishes billing guidance for psychologists. CMS also publishes the Medicare Physician Fee Schedule annually with updated RVUs for these codes.