Name of Manual - Blue Cross and Blue Shield of Minnesota

Code Description Units Who May Submit Misc
96119 Neuropsychological testing (e.g., Halstead-
Reitan neuropsychological battery, Wechsler
memory scales and Wisconsin card sorting
test), with qualified health care professional
interpretation and report, administered by
technician, per hour of technician time, faceto-face
96120 Neuropsychological testing (e.g., Wisconsin
card sorting test), administered by a
computer, with qualified health care
professional interpretation and report
96125 Standardized cognitive performance testing
(e.g., Ross information processing
assessment) per hour of a qualified health care
professional's time, both face-to-face time
administering tests to the patient and time
interpreting these test results and preparing
the report
Report 1 unit
per hour of
face-to-face
testing
Report 1 unit
per testing
session
regardless of
number of tests
Report 1 unit
per hour of
face-to-face
testing,
interpretation
and
preparation of
report
Coding Policies and Guidelines (Behavioral Health)
MD, LP-PhD, LP-MA A technician under direct
supervision, administers
the test(s). The supervising
qualified licensed
practitioner interprets the
test(s) and prepares the
report. Billed under the
supervising licensed
practitioner provider
number or NPI.
MD, LP-PhD, LP-MA Patient is alone and is
taking a computer-based
test. A qualified licensed
practitioner interprets the
test(s) and prepares the
report. Billed under the
licensed practitioner
provider number or NPI.
MD, LP-PhD, LP-MA The psychologist or
psychiatrist administers
and interprets the test(s)
and prepares the report.
Billed under the MD, LP-
PhD, LP-MA individual
provider number or NPI.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual 06/19/12 11-65