CMS Pub. 100-04, ch. 12, § 160

B3-2150, B3-2070.2

See the Medicare Benefit Policy Manual, Chapter 15, for coverage requirements.

There are a number of types of psychologists. Educational psychologists engage in

identifying and treating education-related issues. In contrast, counseling psychologists

provide services that include a broader realm including phobias, familial issues, etc.

Psychometrists are psychologists who have been trained to administer and interpret tests.

However, clinical psychologists are defined as a provider of diagnostic and therapeutic

services. Because of the differences in services provided, services provided by

psychologists who do not provide clinical services are subject to different billing

guidelines. One service often provided by nonclinical psychologist is diagnostic testing.

NOTE: Diagnostic psychological testing services performed by persons who meet these

requirements are covered as other diagnostic tests. When, however, the psychologist is

not practicing independently, but is on the staff of an institution, agency, or clinic, that

entity bills for the diagnostic services.

Expenses for such testing are not subject to the payment limitation on treatment for

mental, psychoneurotic, and personality disorders. Independent psychologists are not

required by law to accept assignment when performing psychological tests. However,

regardless of whether the psychologist accepts assignment, he or she must report on the

claim form the name and address of the physician who ordered the test.