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Insurance Worksheet

These are questions to ask your insurance company to inquire about coverage for neuropsychological and psychological testing. Please call the toll free number that is located on that back of your insurance card.

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Please ask the following questions:

  1. Do I have coverage for psychological and neuropsychological testing?
  2. Ask about the specific codes listed below. It is important to ask about all of the codes listed as the office may bill a combination of codes.
    • 96130,96131,96136,96137 (Psychological Testing Evaluation)
    • 96132,96133,96136,96137 (Neuropsychological Testing Evaluation)
    • 90791 (Diagnostic Interview)
    • 96116,96121 (Neurobehavioral Status Exam)
    • 90837, 90834 (Individual Psychotherapy)
  3. Do I need prior authorization for involving any of the codes above? If so, where can I find the prior authorization form?
  4. Is there a deductible for any of the codes? If so, what is the deductible and how much has been met?
  5. What is the copay and/or coinsurance for the codes listed above?
  6. Keep a record of the following information.
    • Name of the agent assisting
    • Reference number for the call
    • Time and date of the call

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