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December 2016 Texas Medicaid Provider Procedures Manual

Behavioral Health, Rehabilitation, and Case Management Services Handbook : 6 Physician, Psychologist, and Licensed Psychological Associate (LPA) Providers : 6.11 Psychological and Neuropsychological Testing

6.11
Psychological testing (procedure code 96101) and neuropsychological testing (procedure code 96118) are covered services when they are provided by a psychiatrist, psychologist, PLP, or LPA and are limited to the following diagnosis codes:
 
In addition, to the diagnosis codes listed in the table above, procedure code 96118 is a benefit when submitted with the following diagnosis codes:
 
Psychologists licensed by the TSBEP and enrolled as Medicaid providers are authorized to perform counseling and testing for mental illness or debility. LPAs and PLPs licensed by the TSBEP are authorized to perform counseling and testing for mental illness and debility when delegated and supervised by a licensed psychologist.
Psychological and neuropsychological testing are not covered benefits when provided by a CNS, NP, or PA. Each hour of psychological or neuropsychological testing counts toward the 12-hour per day, per provider system limitation.

Texas Medicaid & Healthcare Partnership
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