interpreting test results and preparing the report) 96116 TL 1 hour Neurobehavioral Status or Physician, includes time with the member and time interpreting tests results and preparing the report. Early intervention/individualized family service plan (IFSP). $79.20 $80.92 $80.78 N Procedure Code Modifier Modifier Unit Service Description Maximum Allowance per unit through 7/31/18 Maximum Allowance per unit 8/1/18-6/30/19* Maximum Allowance per unit effective 7/1/19* PA/UR 96116 TM 1 hour Neurobehavioral Status or Physician, includes time with the member and time interpreting tests results and preparing the report. Individualized education plan (IEP). $79.20 $80.92 $80.78 N 96118 1 hour Neuropsychological testing (e.g. Neuropsychological Battery, Wechsler Memory Scales and Wisconsin Card Sorting Test), Psychologist or Physician, includes both face-to-face time administering the tests to the patient and time interpreting these test results and preparing the report. $79.20 $80.92 $80.78 N TL 1 hour Neuropsychological testing (e.g.) Halstead-Reitan Neuropsychological Battery, Wechsler Memory Scales and $79.20 $80.92 $80.78 N
Wisconsin Card Sorting Test, Psychologist or Physician, includes both face-to-face time administering to the member and time interpreting these test results and preparing the report. Early intervention /individualized family service plan (IFSP). Procedure Code Modifier Modifier Unit Service Description Maximum Allowance per unit through 7/31/18 Maximum Allowance per unit 8/1/18-6/30/19* Maximum Allowance per unit effective 7/1/19* PA/UR TM 1 hour Neuropsychological testing (e.g. Neuropsychological Battery, Wechsler Memory Scales and Wisconsin Card Sorting Test)-Psychologist or Physician, includes both face-to-face time administering tests to the member and time interpreting these test results and preparing the report. Individualized education program (IEP). $79.20 $80.92 $80.78 N 96119 1 hour Neuropsychological testing (e.g. Neuropsychological Battery, Wechsler Memory Scales and Wisconsin Card Sorting Test), Psychological Examiner interpretation and report, administered by a technician face-to-face. $50.22 $51.31 $51.22 N TL 1 hour Neuropsychological testing (e.g. Neuropsychological Battery, Wechsler Memory Scales and Wisconsin Card Sorting Test), Psychological Examiner interpretation and report, administered by a technician, face-to-face. $50.22 $51.31 $51.22 N
*H2012 HN UQ TL Hourly Children’s Behavioral Health Day Treatment-BHP Level- UQ four patients served- Services in an early intervention/individualized family service plan (ISFP) $14.65 $14.97 $14.94 Y *H2012 HN UQ TM Hourly Children’s Behavioral Health Day Treatment-BHP Level- UQ four patients served- Services in an individualized education program (IEP) $14.65 $14.97 $14.94 Y HO Hourly Children’s Behavioral Health Day Treatment-Master’s Level $95.00 $97.07 $96.90 Y Procedure Code Modifier Modifier Unit Service Description Maximum Allowance per unit through 7/31/18 Maximum Allowance per unit 8/1/18-6/30/19* Maximum Allowance per unit effective 7/1/19* PA/UR H2012 HO TL Hourly Children’s Behavioral Health Day Treatment-Master’s Level - Services in an early intervention/individualized family service plan (ISFP) $95.00 $97.07 $96.90 Y H2012 HO TM Hourly Children’s Behavioral Health Day Treatment-Master’s Level- Services in an individualized education program (IEP) $95.00 $97.07 $96.90 Y H2012 HO UN Hourly Children’s Behavioral Health Day Treatment-Master’s UN two patients served $47.50 $48.54 $48.45 Y H2012 HO UN TL Hourly Children’s Behavioral Health Day Treatment-Master’s Level UN two patients served- Services in an early intervention/individualized family service plan (ISFP) $47.50 $48.54 $48.45 Y HO UN TM Hourly Children’s Behavioral Health Day Treatment-Master’s Level UN two patients served- Services in an individualized education program (IEP) $47.50 $48.54 $48.45 Y