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HumanaMedicare Advantage · Coverage · Medicare Advantage · IA, KS, MO, NE, IN, MI, IL, MN, WI, CT, MA, ME, NH, NY, RI, VT, KY, OH, AR, CO, LA, MS, NM, OK, TX, DE, DC, MD, NJ, PA, FL, PR · Psychiatry, NeurologyMedium impact

Psychological and Neuropsychological Testing - Medicare Advantage (New)

Effective date
Feb 2, 2026
Identified
Jun 24, 2026

Summary

Humana has released a new Medicare Advantage medical coverage policy for psychological and neuropsychological testing, establishing coverage criteria and billing guidelines for related CPT codes. This policy references multiple Medicare Administrative Contractor (MAC) Local Coverage Determinations across different states to determine medical necessity requirements.

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What to do

Action · 3 steps
01Before February 2, 2026: Billing teams should review and update their psychological and neuropsychological testing billing procedures to align with Humana's new coverage policy.
02Ensure documentation meets the medical necessity criteria outlined in the applicable MAC LCD for your geographic jurisdiction.
03Verify that claims for CPT codes 96105, 96116, 96121, 96125, 96130-96133, 96136-96139, and 96146 include appropriate supporting documentation to demonstrate medical necessity.

Codes mentioned

96105961169612196125961309613196132961339613696137961389613996146

Original notice

Psychological and Neuropsychological Testing - Medicare Advantage (New)
mcp.humana.com · Always check the source before changing claims.
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Related policy hubs

Humana policiesIA policy changesKS policy changesMO policy changesNE policy changesIN policy changesMI policy changesIL policy changesMN policy changesWI policy changesCT policy changesMA policy changesME policy changesNH policy changesNY policy changesRI policy changesVT policy changesKY policy changesOH policy changesAR policy changesCO policy changesLA policy changesMS policy changesNM policy changesOK policy changesTX policy changesDE policy changesDC policy changesMD policy changesNJ policy changesPA policy changesFL policy changesPR policy changesPsychiatryNeurologyCode 96105Code 96116Code 96121Code 96125Code 96130Code 96131Code 96132Code 96133Code 96136Code 96137Code 96138Code 96139Code 96146

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