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96101 psychological testing.

Karen Posted Fri 24th of February, 2017 14:39:51 PM
I am tying to verify some information about code 96101. We are going to be seeing a pt for psychological testing which will last 8 hours. Can I bill this code for 8 units?
SuperCoder Answered Mon 27th of February, 2017 06:04:18 AM

Hi,

 

As per the MUE a maximum of 8 units can be billed in a single date of service for CPT code 96101.

 

 

As per the documentation, if the time spent for performing the psychological testing was for 8 hours, then 8 units can be billed for the time spent.

 

 

96101 reimbursement is for test administration, interpretation and report preparation. The total time that the psychologist / physician spends in administration and conducting the comprehensive interpretation and report based on the testing data is billable under 96101. However, in order for administration time to be billable, it must be face-to-face with the Member.

 

 

NOTE: A minimum of 31 minutes must be provided to report any per hour code.

If the service is not performed for complete 8 hours, then 7 units of 96101 would be billed. In order to bill for the last unit (i.e. 8th unit), a minimum of 31 minute is required.

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