Psychologist billing
Psychologist billing services
We handle billing for psychologists and neuropsychologists, with a focus on psychological and neuropsychological testing, where time units and authorizations decide what gets paid. We also bill intakes and psychotherapy. Claims go out within 24 hours of receiving charges, every denial is worked within 5 business days, and billing starts at 2.5% of collections.
- Testing evaluation and administration codes billed by time unit
- Prior authorization for testing checked before the first session
- Psychologist, technician and computer-administered tests billed correctly
Why psychologist billing is different
Why psychologist billing is different
Testing is where psychologist billing gets hard. One evaluation can span several days, several people and several code families, and each is counted in its own time units.
Evaluation and administration are separate
Testing is split into two parts. Evaluation services (96130–96133) cover interpreting results, integrating data, writing the report and giving feedback. Test administration and scoring (96136–96139) cover the time spent giving tests. The same minutes cannot be counted in both.
Time units and the midpoint rule
Evaluation codes are billed per hour and administration codes per 30 minutes, with a first-unit code and an add-on for each extra unit. Under CPT time rules, a unit generally counts once its midpoint is passed. Total time has to be documented to support every unit.
Who gave the test matters
Tests given by the psychologist use 96136 and 96137. Tests given by a technician use 96138 and 96139. A single computer-administered instrument with automated results uses 96146. Supervision and technician rules vary by payer.
Prior authorization for testing
Many commercial and Medicaid plans require authorization for testing, often with a set number of hours. Billing more hours than approved, or starting before approval, is a common reason for denial.
Coverage exclusions
Some plans exclude testing done mainly for school, learning disability, legal or employment purposes. Coverage for ADHD and autism evaluations varies by plan. We check benefits and medical necessity rules before testing starts.
Multi-day evaluations
Testing often happens over several visits, with the report finished later. Payers differ on which date of service to report and whether units can be split across dates, so we follow each payer’s rule.
Common codes
Psychologist codes we bill often
Testing codes are the focus here. For psychotherapy time ranges, see our therapist billing page.
| Code(s) | What it is | What we watch for |
|---|---|---|
| 96130 / 96131 | Psychological testing evaluation, first hour / each added hour | Time for interpretation, report and feedback documented; not overlapping administration time |
| 96132 / 96133 | Neuropsychological testing evaluation, first hour / each added hour | Neuropsych codes used only for neuropsychological evaluations; units match time |
| 96136 / 96137 | Test administration and scoring by the psychologist, first 30 min / each added 30 min | Total administration time documented; units within the authorization |
| 96138 / 96139 | Test administration and scoring by a technician, first 30 min / each added 30 min | Technician qualifications and supervision rules for the payer |
| 96146 | Single automated instrument, computer-administered | Only for automated, single-instrument results |
| 96116 / 96121 | Neurobehavioral status exam, first hour / each added hour | Separate from testing time; payer bundling edits |
| 90791 | Diagnostic evaluation (intake) | Frequency limits; not the same service as a testing evaluation |
| 90832 / 90834 / 90837 | Psychotherapy, about 30 / 45 / 60 minutes | Session time documented; see therapist billing |
Codes and rules change. We check current CPT guidance and each payer’s policy before submission.
Common denials we prevent
Testing denials we stop before they happen
Most testing denials are about hours, authorizations and who did the work. We check each one during coding review.
- Testing started without an approved authorization, or billed past the approved hours
- Evaluation and administration time overlapping, or units that exceed documented time
- Technician administration billed under the psychologist codes, or the reverse
- Neuropsychological codes used for a standard psychological evaluation
- Testing billed for a purpose the plan excludes, such as school placement
- Units split across dates when the payer wants one date of service, or the reverse
- Missing or nonspecific diagnosis codes that do not support medical necessity
What we handle
Everything between the session and the payment
- Insurance eligibility and benefits checks, including testing coverage and exclusions
- Prior authorization requests and tracking of approved testing hours
- Charge entry and coding review of testing, evaluation and psychotherapy codes
- Claim submission within 24 hours of receiving charges
- Payment posting and ERA reconciliation
- Denial correction, resubmission and appeals within 5 business days
- A/R follow-up on unpaid and underpaid claims
- Credentialing and CAQH upkeep for psychologists
- Patient statements and balance tracking
- Monthly reports on collections, denials and A/R
Behavioral health is our core focus, and our billers work with mental health codes every day. CPB-certified billers are on the team.
Pricing
Clear pricing for psychology practices
Billing starts at 2.5% of collections, or a flat monthly fee. There is no setup fee and no long-term contract. Credentialing starts at $80 per payer, and 5 commercial payers are credentialed free with billing.
Common questions
What is the difference between 96130 and 96136?
96130 covers the psychologist’s evaluation work: interpreting results, integrating data, writing the report and giving feedback. 96136 covers giving and scoring tests, per 30 minutes. Both can be billed for the same evaluation, but the same minutes cannot be counted twice.
How many units of 96131 or 96137 can we bill?
As many as documented time supports, within any authorization. Under CPT time rules, a unit generally counts once its midpoint is passed. Some payers also set their own limits, so we check current policy.
Do you get prior authorization for psychological testing?
Yes. We check whether the plan requires authorization, request it with the documentation the payer asks for and track the approved hours so testing is not billed past the limit.
Can we bill for tests given by a psychometrist?
Often yes, using the technician codes 96138 and 96139. Rules on technician qualifications and supervision vary by payer, and some plans do not pay technician codes. We confirm each payer’s policy first.
Is ADHD or autism testing covered by insurance?
Sometimes. Coverage depends on the plan, the patient’s age and medical necessity. Testing done mainly for school or learning purposes is often excluded. We check benefits before testing starts.
Do you also bill psychotherapy for psychologists?
Yes. We bill intakes, individual, family and group psychotherapy. Billing starts at 2.5% of collections, with no setup fee and no long-term contract.
Guides from our team
Learn more before you decide
90791 vs 90792: Which Psychiatric Diagnostic Evaluation Code to Bill
The difference between 90791 and 90792, who can bill each, what the note must include, codes that cannot be billed the same day, and common intake denials.
Read the guide →90837 vs 90834 vs 90832: Which Psychotherapy Code to Bill
The time rules for 90832, 90834 and 90837, how to document session length, when to add 90785, and how to bill 60-minute sessions without triggering payer audits.
Read the guide →Psychological Testing Billing Codes: 96130, 96131, 96136, 96137, 96138 and 96139 Explained
How to bill psychological and neuropsychological testing: evaluation vs administration codes, time units, technician codes, prior authorization and common denials.
Read the guide →Find out what your claims are leaving on the table
Tell us about your practice. We will review 90 days of claims and show you what is recoverable, at no cost.
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