Reimbursement Tips

• As soon as possible, call your insurance company to determine your coverage for psychological (not educational) testing. Educational assessment does not have a procedure code and is not covered by insurance. For a comprehensive psychoeducational evaluation, the CPT (current procedural terminology) codes would be 96130, 96131, 96136, and 96137.

• If your policy covers psychological testing, ask if steps are needed prior to the evaluation to ensure coverage. Your insurance company may require I complete pre-authorization forms, and I need them at least two weeks prior to the scheduled evaluation date. Be sure to tell them I am an out-of-network provider. Please note, completion of pre-authorization forms does not guarantee services will be considered reimbursable by your insurance company.

• I work with you rather than insurance companies. If the insurance company requires I communicate directly with them, I will need your written authorization, and I will provide you a form to complete.