Mastering the Codes for Seamless Reimbursement
Accurate coding is key to smooth reimbursements and avoiding denials—let’s break it down step by step. Below, we’ll cover the essential CPT codes for neurocognitive testing and how to use them correctly.
Key CPT Codes for Cognitive Testing
CPT Code | Who Administers? | Time Requirement | Key Details |
96136 | Physician/NPP | Min. 16 min | Covers test administration by physician/NPP |
96138 | Technician | Min. 16 min | Tech-administered testing without physician involvement |
96132 | Physician/NPP | Min. 31 min | Test interpretation by physician/NPP |
99483 | Physician/NPP | Not time based | Comprehensive cognitive assessment and care planning |
CPT 96136 & 96138: Neurocognitive Test Administration
96136: Administered by a medical professional—think doctors, doctoral-level clinical psychologists, clinical nurse specialists, nurse practitioners, or physician assistants.
96138: Administered by a technician—yes, that could be your MA, scribe, or even your front desk superhero.
Both of these codes are time-based for 30 minutes, meaning you’ll need to spend at least 16 minutes to properly bill them.
Documentation Tip:Make sure to document the medical reason for the test, the ICD-10 diagnosis, and the total time spent administering the test. And if you’re a tech administering 96138, don’t forget to proctor the test! Whether you’re in person, on the phone, or via Zoom, you’re the guiding hand in the process.
CPT 96132: Test Interpretation
This one’s a 1-hour time-based code, so you’ll need to spend at least 31 minutes on it to bill.
Documentation Tip:When documenting for 96132, include the reason for the test, tests administered, test results, test interpretation, any recommendations for interventions, ICD-10 diagnosis, a summary of your feedback to the patient, family, or caregiver, and the total time spent. It’s all about getting the full picture.
CPT 99483: Cognitive Care Planning
A bit of a rebel in the world of CPT codes, 99483 isn’t time-based but usually takes around an hour to complete. You can only bill it once every 180 days (or every 6 months).
Billing Tip:This one is solo—don’t try to bundle it with other codes! You must bill it alone on its own Date of Service (DOS).
Telehealth Bonus Round!
Good news! All of the CPT codes discussed here can be done via telehealth.
96136, 96138, and 96132: Can be completed via audio-only calls (for now—stay tuned for updates from CMS).
96138: Remember, it needs to be proctored, so make sure someone is there overseeing the test, whether it’s through phone, Zoom, or in the office.
99483: Needs a face-to-face encounter, but Zoom will do just fine!