2019 CPT Code Changes for Psychological Testing, Neuropsychological Testing, and Applied Behavioral Analysis (ABA) Services
By Barbara Griswold, LMFT (November 26, 2018)
On January 1, 2019, the American Medical Association (AMA) will release changes to the Current Procedural Terminology (CPT) code set. While the 335 code changes will not apply to most therapists, there will be significant revisions to psychological testing and neuropsychological testing codes, as well as the Applied Behavior Analysis (ABA) codes, so if you provide these services these are important.
- 2019 Psychological & Neuropsychological Testing CPT Codes
- Crosswalk for 2019 Psychological Testing and Evaluation CPT Codes
- Crosswalk: 2019 Neuropsychological Testing and Evaluation of CPT Codes
- Crosswalk: Single Automated Tests
- APA Article: Testing Code Changes Are Here
- All ABA services for dates of service on or after January 1, 2019 must be billed with the new codes 97151-97158, 0362T and 0373T ONLY.
- HCPCS code G9012 will no longer be listed on the fee schedule. All services billed must be for face-to-face services with the patient except as allowed under CPT code 97151.
- Only one provider can bill for a unit of time, with the exception of CPT codes 97153 and 97155 (direct supervision when the Board Certified Behavior Analyst (BCBA)/Qualified Healthcare Professional (QHP) directs the technician and both are face-to-face with the patient at the same time).
CIGNA also stated that providers should use current ABA fee schedules to estimate 2019 schedules: “For example, if you are currently receiving $20.00 for a 30-minute service, you will receive $10.00 for a 15-minute service with the 2019 CPT codes. When submitting claims, you can list the current rate for the service on the claim form and our system will automatically calculate the rate into 15-minute units.”
Some plans like CIGNA have stated they cannot update provider contracts and fee schedules by January 1. However, they are urging providers to use the new CPT codes on claims after January 1st to ensure claims aren’t denied. CIGNA stated “there will be no need to call CIGNA to update your current authorizations to the new codes.” But, as always, check with the plan you are billing.
AMA Releases 2019 CPT Code Set. (2018, September 5). American Medical Association. Retrieved from https://www.ama-assn.org/ama-releases-2019-cpt-code-set