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Anyone having trouble with Medicare and the new neuropsych codes? 96132 96136 96137..

Billed 96132 (1), 96136 (1), 96137 (3)

Medicare is rejecting my claim stating "Payment is adjusted when performed/billed by a provider of this specialty"
The provider is a PhD, Clinical Psychologist.
I contacted Medicare and the supervisor agreed that this rejection is not accurate. She was unable to put the claim back through and referred me to the AH modifier fact sheet for resolution. This modifier was not required in the past. I resubmitted the claim with the modifier and received the same rejection.

Any input is greatly appreciated!!

Medical Billing and Coding Forum

96118 Neuropsych Billing

Hello-

I started this position 1/2017 and only had a few days of training from a biller who was with this practice for 6 years.
I had noticed that she was billing 96118 with 12 units but we were only getting paid anywhere from 2.5-4 units, only being paid 4 units when its BCBS. Though this year a lot of insurances are denying 96118 12 units – only allowing 8 units to be billed and then still paying anywhere from 2.5-4 units. Anyone else seeing this issue? It’s a lot of time spent for just 2.5 units to be paid for.

Appreciated – thank you!

Medical Billing and Coding Forum