1. APA 2005 The New Psychological and Neuropsychological Testing Codes Antonio E. Puente American Psychological Association August, 20, 2005 Washington, D.C.

2. APA 2005 Acknowledgments  Department of Psychology, UNC-Wilmington  Webster University, San Antonio, Texas  NCPA Board of Directors, Practice Division, & Staff  National Academy of Neuropsychology  Division 40 of APA  Inter-Divisional Health Care Committee; APA  Practice Directorate of the American Psychological Association  American Medical Association’s CPT & RUC Staff  CMS Medical Policy Staff

3. APA 2005 Purpose of Presentation Explain the New Diagnostic Testing Codes and Their Potential Impact on the Practice of Psychology Explain the New Diagnostic Testing Codes and Their Potential Impact on the Practice of Psychology

4. APA 2005 Outline of Presentation Progress Progress History History Process Process Expectations Expectations

5. APA 2005 Process Initial Initial Health Care Advisory Committee (non-MDs) Health Care Advisory Committee (non-MDs) Primary Primary CPT Work Group CPT Work Group CPT Panel CPT Panel Time Frame Time Frame 3-5 years to over a decade 3-5 years to over a decade

6. APA 2005 Process Submit new code descriptors recommendation to AMA, July 2004 Submit new code descriptors recommendation to AMA, July 2004 Presentation of recommended changes to CPT Panel, November 2004 Presentation of recommended changes to CPT Panel, November 2004 Approval by AMA CPT Panel, November, 2004 Approval by AMA CPT Panel, November, 2004

7. APA 2005 Process Review by AMA RUC Research Subcommittee in January, 2005 Review by AMA RUC Research Subcommittee in January, 2005 Review by AMA RUC Panel in February, 2005 Review by AMA RUC Panel in February, 2005 Survey of Codes, February, 2005 Survey of Codes, February, 2005 Analysis of surveys, March, 2005 Analysis of surveys, March, 2005

8. APA 2005 Process Presentation to RUC Committee in April, 2005 Presentation to RUC Committee in April, 2005 Review by CMS during Summer of 2005 Review by CMS during Summer of 2005 Inclusion in the 2006 Physician Fee Schedule Inclusion in the 2006 Physician Fee Schedule

9. APA 2005 History: Context A Decade + Long Involvement with the AMA & the CPT Process A Decade + Long Involvement with the AMA & the CPT Process Initial Focus- Mental Health Codes Initial Focus- Mental Health Codes Continuing Evolution Continuing Evolution Revision of existing mental health codes Revision of existing mental health codes Establishment of biofeedback codes Establishment of biofeedback codes Establishment of neuropsychological codes Establishment of neuropsychological codes Establishment of health & behavior codes Establishment of health & behavior codes

10. APA 2005 History: Current Codes Interview Interview Psychiatric = 90801 Psychiatric = 90801 Neurobehavioral Status = 96115 Neurobehavioral Status = 96115 Testing Testing Psychological = 96100; 96110/11 Psychological = 96100; 96110/11 Neuropsychological = 96117 Neuropsychological = 96117 Aphasia = 96105 Aphasia = 96105 Developmental = 96110/111 Developmental = 96110/111

11. APA 2005 Expectations Neurobehavioral Status Exam Neurobehavioral Status Exam Re-write (different language; same concept) Re-write (different language; same concept) Addition of “Physician/Professional” Work Value Addition of “Physician/Professional” Work Value Psychological Testing Psychological Testing Expansion of existing code Expansion of existing code Addition of “Physician/Professional” Work Value Addition of “Physician/Professional” Work Value Neuropsychological Testing Neuropsychological Testing Expansion of existing code Expansion of existing code Addition of “Physician/Professional” Work Value Addition of “Physician/Professional” Work Value

12. APA 2005 Expectations: Psychological Testing Psychological Testing by Provider Psychological Testing by Provider Psychological Testing by Technician Psychological Testing by Technician Psychological Testing by Computer Psychological Testing by Computer Note: Assumption = Mental Health Dx Codes are used Note: Assumption = Mental Health Dx Codes are used

13. APA 2005 Expectations: Neuropsychological Testing Neuropsychological Testing by Provider Neuropsychological Testing by Provider Neuropsychological Testing by Technician Neuropsychological Testing by Technician Neuropsychological Testing by Computer Neuropsychological Testing by Computer Assumption =Medical Dx codes are used Assumption =Medical Dx codes are used

14. APA 2005 Expectations Net Effect Net Effect Greater Clarity of Professional and Non-Professional Activities Greater Clarity of Professional and Non-Professional Activities Differentiation of professional, technical and computer activity Differentiation of professional, technical and computer activity Accounting/auditing, research, and salary purposes Accounting/auditing, research, and salary purposes Avoidance of Continuation of Reimbursement Strictly Based on Practice Expense Avoidance of Continuation of Reimbursement Strictly Based on Practice Expense Recognition of “Physician/Professional” Work Recognition of “Physician/Professional” Work Ending a 10 year struggle Ending a 10 year struggle Increased Reimbursement Increased Reimbursement