Insurance Billing Standards and Guidelines (June 2023)

IMPORTANT: Addendum added

On this page (revised June 2023) you may read up-to-date Billing Standards and Guidelines that address the elimination of CPT codes 96103 and 96120 at the end of 2018, and the addition in 2019 of new psychological/neuropsychological codes 96130-96139

Effective January 1st, 2019, the new codes went ‘live’, which allowed us to obtain more information about them.

We anticipate that you have an in-house billing person or billing service that has access to this new information as well. While it is our intention to provide you accurate and reliable information, it is ultimately the provider’s responsibility to determine coverage, and submit appropriate codes, modifiers and charges for the services rendered.

Still, for your review, in the event that additional codes may be billable in your practice, we wish to supplement the core Billing Standards and Guidelines with an Addendum to the Insurance Billing Standards and Guidelines. This document contains a summary page and sections with additional documentation for the relevant new codes taken directly from CMS.

Click on the link inside the orange box to download a PDF of the basic Billing Standards and Guidelines (revised June 2023).

Or click HERE to open a PDF (revised June 2023) of the basic Billing Standards and Guidelines in your browser.

Click on the link inside the blue box to download a PDF (revised January 2023) of the Addendum to the Insurance Billing Standards and Guidelines.

Or click HERE to open a PDF (revised January 2023) of the Addendum to the Insurance Billing Standards and Guidelines in your browser.

Questions?

Call 1-866-668-9038 ext 3.