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Expanded Telehealth Benefits Due to COVID-19 in the U.S.

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Please note that Cambridge Brain Sciences can not determine your eligibility for reimbursement and does not assume responsibility over the outcome of any claims. The selection of CPT codes noted below to report the services provided will depend on other procedures performed, associated CCI edits, and other factors.

Please contact your local payer to determine whether you qualify for these codes, and if any additional coding and coverage guidelines exist, such as which providers can perform the service, limits on billable time, or if the use of a modifier is required or allowed.


The COVID-19 pandemic has caused many healthcare providers to rethink how they deliver their services safely and effectively. Many are introducing telemedicine, including remote cognitive assessments. As a result, Cambridge Brain Sciences has received inquiries about reimbursement for telehealth services related to cognitive assessments. Here, we will provide high-level information, including news on changes recently introduced as a result of COVID-19.


Restrictions on Telehealth Have Been Relaxed

The telehealth landscape is changing rapidly in response to COVID-19. In the United States, coronavirus legislation from congress gave the Department of Health and Human Services authority to waive certain Medicare telehealth restrictions. For example, certain site limitations are removed, such that existing telehealth services can now be provided regardless of where the patient is located geographically. This CMS fact sheet contains more details.

These changes are designed to allow qualified healthcare providers to provide services to patients at home, helping to keep in-person visits to a minimum and slow down the spread of the virus. CBS Health’s remote cognitive testing is one tool that may help you continue to perform assessments you would have previously done in-clinic. See our Best Practices for Assessing Patients Remotely article for more advice on switching to email assessments.


What Has Changed With CPT Codes Related to Remote Cognitive Assessments?

Many qualified CBS Health customers are already successfully receiving reimbursement for various services related to cognitive assessments. The CBS Health Reimbursement Guide describes some CPT codes related to the administration of the cognitive assessment itself, as well as other related activities such as exams before assessments, and providing feedback on results after assessments.

The CPT code most relevant to the recent changes is 96116. CPT code 96116 covers neurobehavioural status exams. A CBS Health baseline assessment may be part of this exam. Code 96116 was already listed as a telehealth service, but under new telemedicine guidelines, can be administered remotely in more situations than before. If you are a physician or other qualified healthcare professional, and administer cognitive assessments as part of a neurobehavioural status exam, you may be eligible for reimbursement using code 96116. Note that the add-on code 96121 is not on the telehealth list—organizations such as the APA are attempting to understand whether this is an oversight and are seeking further clarification.

Another CPT code used by some providers when administering remote cognitive assessments is 96146: psychological or neuropsychological automated testing using an electronic platform. While this code is not listed as a telehealth service by CMS, you may wish to check with your local payer to see if this applies to your practice specifically when administering cognitive assessments remotely.

Note that CPT codes 99421-99423 (for physicians) and codes G2061-G2063 (for other titles, such as clinical psychologists and occupational therapists) exist for online digital evaluation and management of established patients. There are no geographic or location restrictions for these e-visits. See the CMS website for more details.

At a state level, depending on your type of practice, title, and location, there may now be additional codes that are relevant to telehealth. Certain states have lifted restrictions on codes beyond those already marked as telehealth services. For example, the West Virginia Department of Health and Human Resources has specifically allowed psychological testing services to be administered through telehealth, which affects CPT codes 96113, 96130, 96131, 96132, 96136, and 96146 (source).

As always, let us know if we can help. Our teams are happy to meet with you one on one to share any information we have learned from other customers. To book a time with a CBS team member, please click here.


Please note that Cambridge Brain Sciences can not determine your eligibility for reimbursement and does not assume responsibility over the outcome of any claims. The selection of CPT codes noted below to report the services provided will depend on other procedures performed, associated CCI edits, and other factors.

Please contact your local payer to determine whether you qualify for these codes, and if any additional coding and coverage guidelines exist, such as which providers can perform the service, limits on billable time, or if the use of a modifier is required or allowed.



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