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Billing for psychological and neuropsychological testing
Act
immediately
Effective date
Not stated in the notice
Identified
Jul 10, 2026
Summary
Point32Health clarifies billing practices for psychological and neuropsychological testing by requiring providers to bill only ONE test type per episode of care. Providers cannot bill both psychological testing codes (96130-96131) and neuropsychological testing codes (96132-96133) together; instead, they must select codes representing the predominant service. Prior authorization forms must also reflect codes from only one testing column.
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What to do
immediately · 5 steps
01Billing team must update all prior authorization request forms and billing workflows to enforce the rule that CPT codes 96130-96131 (psychological testing) and CPT codes 96132-96133 (neuropsychological testing) cannot be billed together in the same episode of care.
02Update the Tufts Health RITogether Prior Authorization Request form and any internal templates to clearly separate psychological and neuropsychological testing columns, requiring providers to check off codes from only ONE column per submission.
03Providers must be notified via provider bulletin that claims submitted with codes from both categories will be denied.
04Billing software rules must be configured to reject claims containing mixed codes.
05Refer providers to the updated Behavioral Health and Substance Use Disorder Payment Policy and the Medical Necessity Guidelines (MNG) on the provider website for clinical criteria and prior authorization requirements.
Codes mentioned
96130961319613296133
Original notice
Billing for psychological and neuropsychological testing
point32health.org · Always check the source before changing claims.