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April 2024
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LCD for Psychological and Neuropsychological Testing (L34646)
See related Articles:
A57481-Billing and Coding: Psychological and Neuropsychological Testing

Contractor Information

Contractor Name: Wisconsin Physicians Service Insurance Corporation - Full list of policies of this Medicare Contractor

Contractor Number: 05401

Contractor Type: MAC A

LCD Information

LCD ID Number: L34646 Status: A-Approved

LCD Title: Psychological and Neuropsychological Testing

Geographic Jurisdiction: Nebraska Other Jurisdictions

Original Determination Effective Date: 10/01/2015

Original Determination Ending Date:

Revision Effective Date: 09/29/2022

Revision End Date:

CMS National Coverage Policy:

Social Security Act 1861(s) Medical And Other Health Services
Social Security Act 1862(a)(7) does not extend coverage to screening procedures.
42 CFR (Code of Federal Regulations):

410.73 Clinical social worker services
410.74 Physician assistants’ services
410.75 Nurse practitioners’ services
410.76 Clinical nurse specialists’ services

MLN Matters Number SE0441 “Incident to” Services.

CMS Publication 100-02: Medicare Benefit Policy Manual, Chapter 15 - Covered Medical and Other Health Services:

§80.2 Psychological and Neuropsychological Tests
§160 Clinical Psychological Services
§170 Clinical Social Worker (CSW) Services
§210 Clinical Nurse Specialist (CNS) Services

CMS Publication 100-03: Medicare National Coverage Determinations (NCD)Manual, Chapter 1- Coverage Determination, Part 1, Sections 10-80:

§30.1 Biofeedback Therapy

CMS Publication 100-04: Medicare Claims Processing Manual, Chapter 12 - Physicians/Nonphysician Practitioners:

§120 Nurse Practitioner (NP) and Clinical Nurse Specialist (CNS) Services Payment Methodology
§120.1 Limitations for Assistant-at-Surgery Services Furnished by Nurse Practitioners and Clinical Nurse Specialist
§150 Clinical Social Worker (CSW) Services
§160 Independent Psychologist Services
§170 Clinical Psychologist Services
§170.1 Payment

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04/17/2024 11:03:36

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