State Leadership Conference
In 2004, the APA Practice Organization successfully advocated for the introduction of seven new Current Procedural Terminology (CPT) codes that are expected to result in increased reimbursement for psychological or neuropsychological testing, reported Kimberley Moore, the APA Practice Directorate's federal regulatory affairs officer, at the 2005 State Leadership Conference session "Successes in advocating for changes in federal and private insurance health policy."
Moore said that the new codes will go into effect in 2006, replacing the three codes that currently apply to psychological testing, the neurobehavioral status exam and neuropsychological testing. The new codes will more accurately reflect the professional time spent by psychologists in administering the tests as well as in interpreting and reporting the test results, she said.
The current code for psychological testing (96100) will be partitioned into three codes, with the exact code numbers yet to be determined. The first new code will include tests administered by the psychologist, the second will cover tests administered by a technician and interpreted by a psychologist, and the third will cover tests administered by a computer and interpreted by a psychologist. The code for neuropsychological testing (96117) will be divided into three new codes along the same lines. There will be only one new code for the neurobehavioral status exam because the entire service is provided only by the psychologist and does not involve the use of technicians or computers.
The next step in solidifying the gains will be assigning professional work values to the codes to reflect psychologists' time and effort in providing the service, noted James Georgoulakis, PhD, a Texas-based private practitioner. This task will be performed by the Health Care Professionals Advisory Committee (HCPAC) to the Resource-based Relative Value Committee. Consisting of representatives of various health organizations, HCPAC includes APA representative Georgoulakis.
"It's great we have the CPT codes, but reimbursement doesn't come with it automatically," Georgoulakis said.
Diane Pedulla, JD, director of federal regulatory affairs for the APA Practice Directorate, spoke about the tremendous growth in payment for psychological health and behavior services by both Medicare and private insurance. She noted that Medicare payments for psychological health and behavior services rose from $1.56 million in 2002 to $6.10 million in 2003. She also said that a recently revised Medicare regulation now allows psychologists to supervise the performance of psychological and neuropsychological testing performed by technicians or other ancillary staff.
Randy Phelps, PhD, the deputy executive director for professional practice, served as the session's discussant.