2025 CPT code 96133
Effective Date: N/A Medicine - Central Nervous System Assessments/Tests Feed
Neuropsychological testing evaluation services, including integration of patient data, interpretation of test results, clinical decision making, treatment planning, report, and interactive feedback, each additional hour (List separately in addition to code for primary procedure).
Modifiers may be applicable depending on the specific circumstances of the service. Refer to current CPT guidelines for modifier usage.
Medical necessity must be established for neuropsychological testing. The documentation should clearly demonstrate the clinical rationale for the testing, linking it to a specific medical or psychological condition.
The physician or other qualified healthcare professional is responsible for selecting, administering, and scoring neuropsychological tests. They integrate patient data, interpret test results, make clinical decisions, develop treatment plans, and provide interactive feedback to the patient and/or family.
In simple words: The provider conducts neuropsychological tests to assess cognitive and behavioral changes after trauma or illness affecting the nervous system. This involves tests of memory, reasoning, language, coordination, problem-solving, attention, and learning ability. The results are interpreted, a diagnosis is made, and a treatment plan is formulated. This code is used for each additional hour spent with the patient, interpreting results, and preparing the report, and is billed in addition to the primary procedure code.
Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, family member(s) or caregiver(s), when performed; each additional hour (List separately in addition to code for primary procedure).
Example 1: A patient with a history of head trauma undergoes neuropsychological testing to evaluate cognitive deficits. The initial evaluation (96132) takes one hour, and an additional hour (96133) is spent discussing the complex findings with the patient and family, and refining the treatment plan., A child suspected of having a learning disability undergoes neuropsychological testing. The initial evaluation (96132) requires one hour. Due to the child's specific challenges, an additional hour (96133) is needed for administering specialized tests and interpreting the results in the context of the child's developmental history., A patient with a neurodegenerative disease is evaluated for cognitive decline. The initial evaluation (96132) lasts for one hour. An additional hour (96133) is spent integrating data from various sources, including previous assessments, medical records, and caregiver reports, to create a comprehensive treatment plan.
Documentation should include the patient's history, reason for testing, specific tests administered, the patient's performance on the tests, interpretation of the results, diagnosis, treatment plan, and interactive feedback provided. Time spent on each component should be documented clearly.
- Specialties:Neurology, Psychiatry, Psychology, Physiatry
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital