Psychiatry Coding & Reimbursement Alert

You Be the Coder:

Get Clarified on Calculating Units of 96102

Question: I would like to know how units are calculated when billing for CPT® 96102? Should we only count the face to face testing with the technician, or should we also include our clinician’s time in interpreting and preparing the test reports? I know that interpreting and preparing reports is a part of this code, but I am wondering if you can count it towards determining the units.

Vermont Subscriber

Answer: When a psychological test is performed by your technician and either your psychiatrist or psychologist only provided interpretations to the test administered by your technician, you will report 96102 (Psychological testing [includes psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, e.g., MMPI and WAIS], with qualified health care professional interpretation and report, administered by technician, per hour of technician time, face-to-face).

You report one unit of 96102 for every one hour that your technician spends time face-to-face with the patient. The minimum time you need for reporting one unit of 96102 is 31 minutes. If the time spent is 30 minutes or less, you cannot report the codes as CPT® time guidelines for the code have not been met. You should be aware that only the time spent by your technician in administering the test is countable while calculating the number of units of 96102 that you will report, since the descriptor says “per hour of technician time.”

The descriptor to 96102 carries the phrase “with qualified health care professional interpretation and report,” which means that the interpretation provided by your clinician is included and cannot be claimed for separately using another code such as 96101 (Psychological testing [includes psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, e.g., MMPI, Rorschach, WAIS], per hour of the psychologist’s or physician’s time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report).

Also, you cannot count the time spent by your clinician in the interpretations for the test and preparing reports while calculating the number of units of 96102. For instance, if your technician administers the test and the duration for this took two hours and your clinician spent another hour in the test interpretation, you will only claim for the technician time face-to-face, which in this instance is two hours. So, you will only report 96102x2 and not three units of the code adding up the hour that your clinician spent in the interpretation.