United Healthcare (UHC) Neuropsychological Testing Coverage Information

When it comes to psychological testing, United Healthcare (UHC) has some specific criteria and guidelines that need to be considered when seeking the coverage for such services. People often have questions about how UHC covers psychological tests and assessments, whether provider referrals are needed, what service codes are used by providers, and if prior authorization is necessary.

United Healthcare Insurance Psychological Testing Guide

UHC Psychological Testing FAQ Table of Contents

Does United Healthcare (UHC) Cover Psychological Testing?

Yes, United Healthcare (UHC) does cover psychological testing. UHC recognizes the importance of diagnostic testing to pinpoint mental health related issues, and they offer several insurance plans that cover this type of service. However, coverage will vary depending on your specific plan. It is important to contact your provider directly to confirm what your policy covers. UHC also offers a variety of mental health services, such as counseling and psychotherapy. It is important to note that each plan has its own criteria for coverage and pre-authorization requirements. Be sure to contact your provider directly regarding any questions you may have about specific coverage details.

How To Find A Reputable United Healthcare Provider For Psychological and Neuropsychological Assessment Services

Finding a reputable United Healthcare provider for psychological and neuropsychological assessment services is possible. UHC has a Provider Directory that can help you find local providers who accept your insurance plan. You can access this directory on their website or by calling the Member Services number on the back of your insurance card. Additionally, talking to family members, friends, or coworkers can be a great source of referrals. It is also important to read reviews, ask questions, and make sure the provider is board certified in their respective fields before booking an appointment.

What's the Criteria For Medical Necessity With UHC Insurance?

When considering medical necessity with UHC insurance, you should know that there are criteria that must be met. UHC requires that the psychological testing be medically necessary, so you must have a reason and plan of care that outlines how the services are necessary for your health. This will usually require a referral from your primary care physician, who will document and explain why the testing is necessary. Additionally, you should be aware that some plans may only cover specific psychological testing procedures.

Do I Need a Prior Authorization For Psychological Testing With UHC Insurance?

When it comes to psychological testing with UHC insurance, you may need a prior authorization. A prior authorization is when your physician requests pre-approval from the insurance company before any services are rendered, and it explains why the services are medically necessary. This will also require that you show proof of the diagnosis and plan of care to make sure that the testing is appropriate for your situation. UHC will review this request and determine if they will cover the cost of psychological testing based on their criteria.

What CPT Service Codes Do UHC Providers Use For Psychological and Neuropsychological Testing?

United Healthcare providers often use CPT (Current Procedural Terminology) service codes for psychological and neuropsychological testing. The CPT codes are used to communicate the services provided, including the type of test, duration, method of administration, etc. UHC may require that you submit a CPT code with your claim, so it is important to make sure you understand each code that is associated with a particular service.

Psychological assessments are divided into three appointments, each with its own set of billing codes. The intake appointment is billed using CPT code 90791, while the testing, scoring, interpretation, and write-up portion may use a combination of CPT codes 96130, 96131, 96132, 96133, 96136, 96137, 96138, and 96139. The feedback session is billed using CPT code 90837. The total cost for these services is usually in the range of $2300-$2700, but this may vary depending on insurance plans and reimbursement rates, which are subject to change. The final cost of the assessments can only be determined after the claim has been processed by the insurance company.

Can UHC Deny My Psychological Testing Claim After Services Have Been Rendered?

Yes, United Healthcare can deny your psychological testing claim after services have been rendered. UHC will review the submitted claims and determine if they meet the criteria for coverage. If there is insufficient documentation or if it does not meet their guidelines, your claim may be denied. Additionally, if you receive a denial, you can file an appeal with UHC to explain why the services were medically necessary and provide more evidence of your diagnosis. It is important to know that UHC may require additional information before they will reconsider your claim. Ultimately, the subscriber is always 100% responsible for the final bill that may be owed to the provider of services.

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