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