{"id":450,"date":"2014-08-29T01:35:07","date_gmt":"2014-08-29T01:35:07","guid":{"rendered":"http:\/\/wp\/?page_id=11"},"modified":"2024-02-20T17:28:29","modified_gmt":"2024-02-21T01:28:29","slug":"physician-reimbursement","status":"publish","type":"page","link":"https:\/\/staging.screen-inc.com\/?page_id=450","title":{"rendered":"Physician Reimbursement"},"content":{"rendered":"\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-lsv3x698-1bb1c803b91ead38449c771d71386918\">\n#top .av-special-heading.av-lsv3x698-1bb1c803b91ead38449c771d71386918{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-lsv3x698-1bb1c803b91ead38449c771d71386918 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-lsv3x698-1bb1c803b91ead38449c771d71386918 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-lsv3x698-1bb1c803b91ead38449c771d71386918 av-special-heading-h1 blockquote modern-quote modern-centered  avia-builder-el-0  el_before_av_layout_row  avia-builder-el-no-sibling '><h1 class='av-special-heading-tag '  itemprop=\"headline\"  >Covered by Medicare and Most Private Insurance<\/h1><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div>\n<\/div><\/div><\/div><!-- close content main div --><\/div><\/div><div id='av-layout-grid-1'  class='av-layout-grid-container av-287ah6-81f3f660d5ef5d0981e3cf6de7b10125 entry-content-wrapper main_color av-flex-cells  avia-builder-el-1  el_after_av_heading  el_before_av_layout_row  grid-row-not-first  container_wrap sidebar_right'  >\n<div class='flex_cell av-20fe36-7a3662c76a44741588fe2a2ecb0add98 av-gridrow-cell av_one_fourth no_margin  avia-builder-el-2  el_before_av_cell_one_half  avia-builder-el-first '  ><div class='flex_cell_inner'><\/div><\/div><div class='flex_cell av-1un56a-7415d223e495843c19f32331c93bccf9 av-gridrow-cell av_one_half no_margin  avia-builder-el-3  el_after_av_cell_one_fourth  el_before_av_cell_one_fourth '  ><div class='flex_cell_inner'><section  class='av_textblock_section av-lsv3nc8i-f9a0595667f8638b393a5259c95d940b '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p>Screen, Inc. is committed to integrity in billing and resource management and we encourage our customers to do the same. We recommend billing for the CANS-MCI with two primary procedure codes. Add-on codes can be utilized when additional time is necessary for treatment or planning.<\/p>\n<p>The codes that we recommend billing with the CANS-MCI, which generally fit best within the CPT code definitions, are 96136, 96137 and 96132.<\/p>\n<ul>\n<li><b>CPT 96136<\/b> \u2013 Psychological or neuropsychological test administration and scoring* (first 30 minutes)<\/li>\n<li><b>CPT 96137<\/b> \u2013 Each additional 30 minutes* (add-on code)<\/li>\n<li><b>CPT 96132<\/b> \u2013 Neuropsychological testing evaluation services by physician or other qualified\u00a0healthcare professional* (first hour)<\/li>\n<\/ul>\n<p><em>* 30 minute codes require a minimum of 16 minutes; 1 hour codes require a minimum of 31 minutes.<\/em><\/p>\n<\/div><\/section>\n<\/div><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-1r511u-8856f3ee8d53fd0a48eea5c1402abe72\">\n.flex_cell.av-1r511u-8856f3ee8d53fd0a48eea5c1402abe72{\nvertical-align:top;\n}\n<\/style>\n<div class='flex_cell av-1r511u-8856f3ee8d53fd0a48eea5c1402abe72 av-gridrow-cell av_one_fourth no_margin  avia-builder-el-5  el_after_av_cell_one_half  avia-builder-el-last '  ><div class='flex_cell_inner'><\/div><\/div>\n<\/div>\n<div id='av-layout-grid-2'  class='av-layout-grid-container av-5ovci-9c607c7bbb83847c026412fd622d4dca entry-content-wrapper main_color av-flex-cells  avia-builder-el-6  el_after_av_layout_row  el_before_av_layout_row  grid-row-not-first  container_wrap sidebar_right'  >\n<div class='flex_cell av-1dohdm-0a264bfafb5452d4dbf79db4227b6d51 av-gridrow-cell av_one_fourth no_margin  avia-builder-el-7  el_before_av_cell_one_half  avia-builder-el-first '  ><div class='flex_cell_inner'><\/div><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-lsv3qctt-465163a21ba5b02b4a7e8f148d8ea447\">\n.flex_cell.av-lsv3qctt-465163a21ba5b02b4a7e8f148d8ea447{\nvertical-align:top;\nbackground-color:#f2e146;\n}\n<\/style>\n<div class='flex_cell av-lsv3qctt-465163a21ba5b02b4a7e8f148d8ea447 av-gridrow-cell av_one_half no_margin  avia-builder-el-8  el_after_av_cell_one_fourth  el_before_av_cell_one_fourth '  ><div class='flex_cell_inner'><section  class='av_textblock_section av-lsv3p3wd-fe3b8d57c9c296c2bef7c55b58f1c0a4 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p style=\"text-align: center;\">We recommend caution when a company offering a cognitive test promises reimbursement amounts above the industry standard and outside of responsible billing practices. We are happy to make billing recommendations but ultimately it is the provider\u2019s responsibility to determine coverage and submit appropriate codes, modifiers, and charges for the services rendered.<\/p>\n<\/div><\/section>\n<\/div><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-195keq-a3411301b7565d924db1f6cb088ecab4\">\n.flex_cell.av-195keq-a3411301b7565d924db1f6cb088ecab4{\nvertical-align:top;\n}\n<\/style>\n<div class='flex_cell av-195keq-a3411301b7565d924db1f6cb088ecab4 av-gridrow-cell av_one_fourth no_margin  avia-builder-el-10  el_after_av_cell_one_half  avia-builder-el-last '  ><div class='flex_cell_inner'><\/div><\/div><\/div><div id='av-layout-grid-3'  class='av-layout-grid-container av-10d4fm-fab7d519ae6c7d80e38fd41dec6d1b51 entry-content-wrapper main_color av-flex-cells  avia-builder-el-11  el_after_av_layout_row  el_before_av_layout_row  grid-row-not-first  container_wrap sidebar_right'  >\n<div class='flex_cell av-vcs5e-540ed2bf361a51aa9d97b117bc596b32 av-gridrow-cell av_one_fourth no_margin  avia-builder-el-12  el_before_av_cell_one_half  avia-builder-el-first '  ><div class='flex_cell_inner'><\/div><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-lsv3rsg8-c86d638df1013962e0c7ab15da1d974f\">\n.flex_cell.av-lsv3rsg8-c86d638df1013962e0c7ab15da1d974f{\nvertical-align:top;\n}\n<\/style>\n<div class='flex_cell av-lsv3rsg8-c86d638df1013962e0c7ab15da1d974f av-gridrow-cell av_one_half no_margin  avia-builder-el-13  el_after_av_cell_one_fourth  el_before_av_cell_one_fourth '  ><div class='flex_cell_inner'><section  class='av_textblock_section av-lsv3s2dy-7eaa8c11b88b06acfafdde9c15809113 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p style=\"text-align: left;\">For our customers who also wish to offer comprehensive care planning services, CPT 99483 may be provided to patients with established cognitive impairment. Contact us at 866-668-9038, ext 3, for further information.<\/p>\n<\/div><\/section>\n<\/div><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-opyxe-ea23fbd832f1f467693b86013e599eb9\">\n.flex_cell.av-opyxe-ea23fbd832f1f467693b86013e599eb9{\nvertical-align:top;\n}\n<\/style>\n<div class='flex_cell av-opyxe-ea23fbd832f1f467693b86013e599eb9 av-gridrow-cell av_one_fourth no_margin  avia-builder-el-15  el_after_av_cell_one_half  avia-builder-el-last '  ><div class='flex_cell_inner'><\/div><\/div>\n<\/div><\/p>\n<div id='av-layout-grid-4'  class='av-layout-grid-container av-k8282-853403e70a2a0e6eef6443517703fe3c entry-content-wrapper main_color av-flex-cells  avia-builder-el-16  el_after_av_layout_row  el_before_av_section  grid-row-not-first  container_wrap sidebar_right'  >\n<div class='flex_cell av-eal1e-ae55d04b45287bc9a925e3f716f3d4a4 av-gridrow-cell av_one_fourth no_margin  avia-builder-el-17  el_before_av_cell_one_half  avia-builder-el-first '  ><div class='flex_cell_inner'><\/div><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-lsv3re2h-ac31dd95fe03ea1d2f00612c882bd43a\">\n.flex_cell.av-lsv3re2h-ac31dd95fe03ea1d2f00612c882bd43a{\nvertical-align:top;\nbackground-color:#46cff2;\n}\n<\/style>\n<div class='flex_cell av-lsv3re2h-ac31dd95fe03ea1d2f00612c882bd43a av-gridrow-cell av_one_half no_margin  avia-builder-el-18  el_after_av_cell_one_fourth  el_before_av_cell_one_fourth '  ><div class='flex_cell_inner'><section  class='av_textblock_section av-lsv3r0mb-7ac77e62d615cd5567e57e1f1f14df53 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p style=\"text-align: center;\">The national average reimbursement for the CANS-MCI using CPT codes 96136 and 96137 is $85.48. \u00a0If a follow-up appointment using CPT 96132 is added, total average reimbursement is $218.02.<\/p>\n<\/div><\/section>\n<\/div><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-887xe-fba87fd9fd771f7ebdd4e7a509f018b5\">\n.flex_cell.av-887xe-fba87fd9fd771f7ebdd4e7a509f018b5{\nvertical-align:top;\n}\n<\/style>\n<div class='flex_cell av-887xe-fba87fd9fd771f7ebdd4e7a509f018b5 av-gridrow-cell av_one_fourth no_margin  avia-builder-el-20  el_after_av_cell_one_half  avia-builder-el-last '  ><div class='flex_cell_inner'><\/div><\/div>\n<\/div>\n<div id='av_section_1'  class='avia-section av-av_section-654b1c7705265415fbff3f4ed6a2a9e7 main_color avia-section-default avia-no-border-styling  avia-builder-el-21  el_after_av_layout_row  el_before_av_layout_row  avia-bg-style-scroll container_wrap sidebar_right'  ><div class='container av-section-cont-open' ><div class='template-page content  av-content-small alpha units'><div class='post-entry post-entry-type-page post-entry-450'><div class='entry-content-wrapper clearfix'>\n<div  class='flex_column av-av_one_fourth-7c009bd1f92d9d96958f8bb0734cda24 av_one_fourth  avia-builder-el-22  el_before_av_one_half  avia-builder-el-first  first flex_column_div  '     ><\/div><div  class='flex_column av-av_one_half-996a46e18e220f9c516c58236e24bfc9 av_one_half  avia-builder-el-23  el_after_av_one_fourth  el_before_av_one_fourth  flex_column_div  '     ><section  class='av_textblock_section av-lsv41ykb-f6f780f8afce137c7f980c665718162a '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><h3>Medicare Billing Rates<\/h3>\n<hr \/>\n<p>Medicare Payments for CNS Assessments\/Tests and Follow-up Patient Visits<\/p>\n<\/div><\/section><br \/>\n<div class='avia-data-table-wrap av-av_table-50e186637ed9ed16c605214627a3a44d avia_responsive_table avia-table-1'><table  class='avia-table avia-data-table avia_pricing_default  avia-builder-el-25  el_after_av_textblock  avia-builder-el-last '  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/Table\" ><tbody><tr class='avia-heading-row'><th class=''>HCPC\/CPT<\/th><th class=''>Description<\/th><th class=''>Physician Fee (National)**<\/th><\/tr><tr class=''><td class=''>96136<\/td><td class=''>Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; first 30 minutes.<\/td><td class=''>$44.99<\/td><\/tr><tr class=''><td class=''>96137<\/td><td class=''>Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; each additional 30 minutes (add-on code).<\/td><td class=''>$40.49<\/td><\/tr><tr class=''><td class=''>96132<\/td><td class=''>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; first hour.<\/td><td class=''>$132.54<\/td><\/tr><\/tbody><\/table><\/div><style type='text\/css'>.avia-table-1 td:nth-of-type(1):before { content: 'HCPC\/CPT'; } .avia-table-1 td:nth-of-type(2):before { content: 'Description'; } .avia-table-1 td:nth-of-type(3):before { content: 'Physician Fee (National)**'; } <\/style><\/p><\/div><div  class='flex_column av-av_one_fourth-996a46e18e220f9c516c58236e24bfc9 av_one_fourth  avia-builder-el-26  el_after_av_one_half  avia-builder-el-last  flex_column_div  '     ><\/div><\/div><\/div><\/div><!-- close content main div --><\/div><\/div><div id='av-layout-grid-5'  class='av-layout-grid-container av-av_layout_row-575c31e8c6cc3da0551a44f6e7e59d11 entry-content-wrapper main_color av-flex-cells  avia-builder-el-27  el_after_av_section  avia-builder-el-last  grid-row-not-first  container_wrap sidebar_right'  >\n<div class='flex_cell av-av_cell_one_fourth-f73a11ccd29996a2a11249d534554c23 av-gridrow-cell av_one_fourth no_margin  avia-builder-el-28  el_before_av_cell_one_half  avia-builder-el-first '  ><div class='flex_cell_inner'><\/div><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_cell_one_half-3da0cbd1b33d6fcbf39a0678abecaaa4\">\n.flex_cell.av-av_cell_one_half-3da0cbd1b33d6fcbf39a0678abecaaa4{\nvertical-align:top;\n}\n<\/style>\n<div class='flex_cell av-av_cell_one_half-3da0cbd1b33d6fcbf39a0678abecaaa4 av-gridrow-cell av_one_half no_margin  avia-builder-el-29  el_after_av_cell_one_fourth  el_before_av_cell_one_fourth '  ><div class='flex_cell_inner'><section  class='av_textblock_section av-lsv3vvj4-55a65aa77d96eef404ae2c05e6670ff2 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><section class=\"container\">\n<div class=\"row\">\n<div class=\"spb_content_element col-sm-6 spb_text_column\">\n<div class=\"spb_wrapper clearfix\">\n<p>** Medicare reimbursement information (national and regional) can also be found on the CMS website.<\/p>\n<ul>\n<li><a href=\"https:\/\/www.cms.gov\/apps\/physician-fee-schedule\/license-agreement.aspx\" target=\"_blank\" rel=\"noopener\">Physician Fee Schedule Search<\/a>: At the bottom of this page \u2018License for Use of Current Procedural Terminology, Fourth Edition (\u201cCPT\u00ae\u201d)\u2019, click \u2018Accept\u2019. On the \u2018Physician Fee Schedule Search\u2019 page \u2018Selected Criteria\u2019 section drop-down boxes, under \u2019Year\u2019, select \u20182020\u2019; under \u2018Type of Info\u2019, select \u2018Pricing Information\u2019; under \u2018HCPCS Criteria\u2019, select \u2018Single HCPCS Code\u2019; under \u2018MAC Option\u2019 select \u2018Specific Locality\u2019; under \u2018HCPCS\u2019, select CPT code (96136, 96137, 96132); under \u2018Modifiers\u2019, select \u2018All Modifiers\u2019; and then under \u2018Locality\u2019, find your local region. Click \u2018Update Results\u2019 box. Results will appear below. Most practices will fall under \u2018Non-Facility Price\u2019.<\/li>\n<li><a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search?Y=0&amp;T=4&amp;HT=0&amp;CT=3&amp;H1=96137&amp;M=5\" target=\"_blank\" rel=\"noopener\">Search for Local Coverage Determinations<\/a>: Under \u201cHCPCS Code\u201d enter CPT code (96136, 96137 or 96132), Under \u201cMAC Option\u201d select \u201cSpecific Locality\u201d, and in \u201cSpecific MAC Locality\u201d enter your location.<\/li>\n<\/ul>\n<p>You can also check the Fee Schedule posted by your locale\u2019s Medicare Administrator.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<section class=\"container\">\n<div class=\"row\">\n<div class=\"spb_content_element col-sm-3 spb_text_column\">\n<div class=\"spb_wrapper clearfix\"><\/div>\n<\/div>\n<div class=\"spb_content_element col-sm-6 spb_text_column\">\n<div class=\"spb_wrapper clearfix\">\n<h4>LIMITATIONS ON MEDICARE INFORMATION PROVIDED IN THIS WEBSITE<\/h4>\n<p>The information provided on Physician Fees\/Medicare Reimbursement is widely available to the general public, and is meant to be broadly informative for physicians; but not definitive.<\/p>\n<p>Since physician fees under Medicare reimbursement routinely change (according to changes in RVUs, conversion factors and GPCIs)\u2014and since the applicability of many of the codes themselves change (HCPC\/CPT\/ICD-10)\u2014physicians, not Screen Inc., have sole responsibility for ensuring that they are following all billing requirements of Medicare and all other payer requirements.<\/p>\n<p>The information on this page is current as of March, 2023. Please check with your billing experts, Medicare, and\/or your insurance carriers before billing for any services.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<\/div><\/section>\n<\/div><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_cell_one_fourth-e102f07aee4aa90321b8ecb5743696db\">\n.flex_cell.av-av_cell_one_fourth-e102f07aee4aa90321b8ecb5743696db{\nvertical-align:top;\n}\n<\/style>\n<div class='flex_cell av-av_cell_one_fourth-e102f07aee4aa90321b8ecb5743696db av-gridrow-cell av_one_fourth no_margin  avia-builder-el-31  el_after_av_cell_one_half  avia-builder-el-last '  ><div class='flex_cell_inner'><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-450","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/staging.screen-inc.com\/index.php?rest_route=\/wp\/v2\/pages\/450","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/staging.screen-inc.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/staging.screen-inc.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/staging.screen-inc.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/staging.screen-inc.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=450"}],"version-history":[{"count":29,"href":"https:\/\/staging.screen-inc.com\/index.php?rest_route=\/wp\/v2\/pages\/450\/revisions"}],"predecessor-version":[{"id":907,"href":"https:\/\/staging.screen-inc.com\/index.php?rest_route=\/wp\/v2\/pages\/450\/revisions\/907"}],"wp:attachment":[{"href":"https:\/\/staging.screen-inc.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=450"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}