Psychological and Neuropsychological Testing Billing

Medtransic bills psychological and neuropsychological testing for psychologists, neuropsychologists and the psychiatric and nurse practitioner practices that test. We check each plan's authorization rules and get approval before testing starts, track the approved units, and bill evaluation, professional administration and technician time as the separate parts payers expect. We work inside SimplePractice, TherapyNotes or the system you already use. Billing is 4-8% of what we collect for you. There is no long-term contract.

Last reviewed 2026-10-04.

Why testing claims come back short

A full evaluation is many hours of work spread over several visits and several people. Most lost testing revenue comes from time recorded in the wrong place or testing the plan never agreed to pay for.

  1. Technician hours billed as the psychologist's, or the reverse

    Medicare pays administration and scoring by a technician separately from administration and scoring by the professional. Each has its own codes. If the claim does not show who sat with the patient, the evaluation is underpaid or wrong.

  2. Time reported one visit at a time

    CMS says that when the clinician does the testing, total time is reported once the whole evaluation is complete. Reporting it visit by visit goes against that guidance and invites corrections.

  3. A school-age ADHD evaluation denied as educational

    Aetna does not cover testing done for educational reasons, and Evernorth does not cover testing used mainly to improve academic performance. Make sure the referral states the clinical question, not only the school concern.

  4. The claim went to the wrong benefit

    Aetna considers testing for a mental health diagnosis under the mental health benefit. Testing for a medical diagnosis, such as a brain injury, stroke or dementia, goes under the medical benefit. Sent to the wrong side, the claim is denied.

  5. Long batteries with no reason given for each test

    WPS, a Medicare contractor, may ask for medical necessity when testing runs past eight hours. It does not accept standard batteries unless each test in the battery is medically necessary.

Who handles what in a testing practice

What we run

What stays with you

Your EHR shows what you billed. Your portal shows what we are doing about it.

Your EHR or practice management system runs your practice, but it does not show you our work. The Medtransic HIPAA Compliant Portal does: every claim and its current stage, the denials we are working, your A/R by age, each payer application and its in-network date, and the documents we still need from you. It is the same record our team works from, and it comes with every client account.

Did that claim get paid?

Every claim with its stage and amount, the denials we're working, and your receivables by age.

Where is my application with Aetna?

Each payer application shows its stage, its history, and the date you can start seeing that payer's patients.

What do you still need from me?

One list of the documents we're waiting on. Upload once, and it reaches every payer that asked for it.

It works in any browser, on your desk or your phone. iPhone and Android apps are coming soon. See the client portal.

How Medicare pays a testing evaluation, part by part

Medicare does not pay testing as one service. It pays each part of the work separately, and Evernorth's policy lists the same parts. Therapy billing for psychologists is on our psychology page.

Evaluation services. This is the clinician's thinking work: combining the patient data, interpreting the test results, clinical decision making, treatment planning, the report and feedback to the patient or family. It is billed as a first hour plus each added hour. Psychological and neuropsychological evaluations have separate codes.

Administration and scoring by the professional. When the psychologist or another qualified professional gives and scores two or more tests, the time is billed as a first 30 minutes plus each added 30 minutes.

Administration and scoring by a technician. Technician time uses the same first 30 minutes plus added 30 minutes structure, under separate codes. It is billed on the hours the technician spends face to face with the patient. Medicare pays it at different rates in facility and non-facility settings.

Computer-administered tests. A test the patient completes on a computer is billed once, however long it takes. Like technician time, its Medicare rate depends on the setting.

Neurobehavioral status exam. This is a separate service from the testing itself. It is billed as a first hour plus each added hour.

The report closes the episode. WPS requires testing to produce a report for the referring provider. When the clinician does the testing, CMS has total time reported once the whole evaluation is done.

Who can bill Medicare for testing, and getting them enrolled

Medicare lists who may bill for psychological and neuropsychological tests. We confirm where each of your clinicians fits before we file anything.

  1. Clinical psychologists, NPs, CNSs and PAs

    Clinical psychologists can bill for testing. So can nurse practitioners, clinical nurse specialists and physician assistants, to the extent their state scope of practice allows. All four are required by law to accept assignment for testing.

  2. Independently practicing psychologists

    A psychologist who is not a clinical psychologist and practices independently is covered only when a physician orders the tests. The claim must carry the name and address of the ordering physician.

  3. Psychologists on a clinic's staff

    When the psychologist who tests is on the staff of an institution, agency or clinic, that organization bills for the tests, not the psychologist.

  4. Physical, occupational and speech therapists

    Medicare lets PTs, OTs and SLPs bill for testing too, but only for three specific test codes. We check which ones before a therapist's testing goes on a claim.

  5. Commercial payers, one application each

    We credential each clinician who bills with each commercial plan you want. We file each application and follow it to an effective date, and you can watch its stage in your client portal.

Credentialing is $150 per application, per provider. In our experience it usually takes 60 to 90 days with each payer.

Supervision rules and payer limits on testing

Medicare: technicians may test under general supervision

The federal regulation allows testing under general supervision. The supervisor directs the work but does not have to be present. A physician or clinical psychologist can supervise, and so can a nurse practitioner, clinical nurse specialist, physician assistant, certified registered nurse anesthetist or certified nurse-midwife, as far as scope of practice and state law allow.

WPS states: follow the stricter local rule

WPS's local coverage policy for Iowa, Kansas, Missouri, Nebraska, Indiana and Michigan still says a technician who gives neuropsychological tests must be directly supervised by the provider. It was in effect when we checked on October 4, 2026. If WPS is your Medicare contractor, plan for direct supervision until WPS changes the policy.

WPS: testing it will not pay for

WPS does not cover testing for educational or vocational purposes that do not shape medical care. Nor does it cover testing when no problem with brain function is suspected, or repeat testing not needed for medical decisions.

Aetna: school, ADHD, court and disability testing

Aetna does not cover testing for educational reasons, or for employment, disability qualification or legal purposes. It calls testing rarely medically necessary for uncomplicated ADHD, but possibly necessary when ADHD is neurologically complicated, such as after head trauma or with seizures. It also expects the hours requested to be reasonable for the clinical questions.

Aetna: autism evaluations and substance use

Aetna lists testing with standardized parent interviews and structured behavioral observation to diagnose pervasive developmental disorders, and points to its autism policy. Testing is not medically necessary during active substance use, withdrawal or early recovery, because the results may be invalid.

Evernorth (Cigna): a clinical reason from its list

Under Evernorth's policy effective September 15, 2026, neuropsychological testing must inform clinical decisions and needs a reasonable suspicion of a listed condition. Autism, dementia and brain injury are on the list. Testing used mainly for education, academic performance, baseline function or screening is not covered.

When a testing practice may not need us

If most of your testing is forensic, pre-employment or school-funded, it sits outside health insurance. Aetna, for one, does not cover legal, employment or disability testing, so there is little for a billing company to collect.

If you only want help choosing tests or writing reports, that is clinical work and stays with you. We handle the authorizations, claims and payments around it.

Questions testing practices ask us

Can a technician give the tests?

Yes. Medicare's regulation allows testing under the general supervision of a psychologist, physician or other qualified practitioner, and technician time has its own billing codes. WPS's local policy still requires direct supervision of technicians, so check your Medicare contractor first.

Will insurance pay for ADHD testing?

It depends on the plan and the reason. Aetna says testing is rarely medically necessary for uncomplicated ADHD but may be when there are neurological complications. Neither Aetna nor Evernorth covers testing done mainly for school purposes.

Is autism testing covered?

Both Aetna and Evernorth list autism among the reasons testing can be medically necessary. Evernorth also notes that a number of states require regulated plans to cover services for autism spectrum disorder.

Is court-ordered or disability testing covered?

Aetna does not cover testing for employment, disability qualification or legal purposes, because it is not treatment of disease. Plan to bill that work outside insurance.

Do you get testing authorized before we start?

Yes. We check each plan's rules, request the hours your clinical questions need and track the approved units. If testing needs more time, we ask before you go over.

What does Medtransic charge a testing practice?

Billing is 4-8% of collections, with no long-term contract. Credentialing is $150 per application, per provider. The revenue audit before you sign is free.

Sources

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