Neuropsychological/psychological testing

Neuropsychological tests are usually performed to evaluate neurological or neuropsychiatric disorders such as traumatic brain injury and brain concussion, multiple sclerosis and cerebral vascular accidents. The results often provide valuable information about the patient's neurocognitive functioning. Neuropsychological tests are also designed to evaluate a member's ability in concentration, memory, reading, comprehension, judgment, and ability to interpret and process information. Visual perception, movement, coordination and a psychological profile may also be performed. These tests make up a part of the overall medical evaluation and the results aid in the development of a treatment plan.

Psychological tests are designed to measure a member's level of intelligence, personality, academic function and/or dimensions of psychopathology and attitudes and behavior. These tests make up a part of the overall evaluation process with results aiding in diagnosis and development of a treatment plan.

Neuropsychological testing is covered as a medical benefit.

Prior authorization is not required for participating providers.

Prior authorization is not needed for neuropsychological testing as part of a pre-surgical or pre-medical program if the associated medical services have been prior authorized. Its purpose is to identify cerebral dysfunction manifesting as behavioral, cognitive or emotional difficulties, and so it is used predominantly for medical-surgical or comorbid conditions.

Prior authorization is required for out of network providers. Submit requests for neuropsychological testing by using our Medical prior authorization form, attach necessary clinical information and fax to 888.647.6152.

See medical policy for covered and non-covered codes.

• See Outpatient mental health treatment page for billing code information.
• See Behavioral health provider billing for relevant fee schedules and provider requirements.

Psychological testing is covered by the member's behavioral health benefit when medically necessary. Prior authorization is not required for participating providers.

See policy for details and limitations.

Prior authorization is not needed for psychological testing as part of a pre-surgical or pre-medical program if the associated medical services have been prior authorized.

Prior authorization is not required for participating providers.

Prior authorization is required for out of network providers.

If you’re a provider located within the state of Michigan and would like to join our provider network, visit our credentialing application page.

Submit authorization requests for psychological testing by using our Behavioral Health Authorization Form, attach necessary clinical information and fax to our Behavioral Health department at 616.975.0249.

Visit our Behavioral Health provider billing page.