Psychological Testing

ADHD Testing Services

Overview

Optima Behavioral Health (OBH) provides psychological testing services for Attention-Deficit/Hyperactive Disorder (ADHD). The ADHD testing services takes place over the course of a few visits, and is comprised of several different psychological tests. We ask that any potential patients that are interested or have been referred for this service to check with their insurance company regarding coverage. Please see the below sections for more information on the service and what patient's should discuss with their insurance companies.


Billing Codes

For ADHD testing we will bill out the following codes based on patient status at OBH.


For outside referrals (brand new to the practice) we will bill the following: 90791 (1 unit), 96130 (1 unit), 96136 (1 unit), 96137 (1+ unit, add-on to 96136, optional), and 96131 (1 unit). 


For internal referrals (patient referred within OBH) we will bill the following: 96130 (1 unit), 96136 (1 unit), 96137 (1+ unit, add-on to 96136, optional), and 96131 (1 unit). 


What should I ask my insurance company?

The following questions should be asked of your insurance company:

  1. Does my plan cover psychological testing for ADHD?
  2. Does my plan cover psychological testing when performed by a master's level therapist (e.g. not a licensed psychologist)?
  3. Does my plan require prior authorization for these services? If yes, ask your insurance to contact our office to setup authorization or let our office know if we need to call into your insurance.


Important Note on Coverage

OBH psychological testing is provided by master's level psychotherapists that are operating within the scope of their license within the state of Ohio. Not all insurance companies will cover psychological testing when not performed by a licensed psychologist. It is very important to clarify with insurance companies on the credentialing level needed for psychological testing services. While OBH will try to assist with getting prior authorization for psychological testing it is important to remember that your insurance makes the ultimate decision on coverage at the time they process your claims. If authorization is obtained but then not honored by an insurance company the balance from the services provided then becomes patient responsibility.

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