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PSYCHOLOGICAL
SERVICE FEE MEMORANDUM MS-CE-01-02-16 DATE:
May 17, 2002
AMENDED
DATE:
July 1, 2003 RE:
Psychological Fee Schedule
Stanford Binet, or Equivalent with Standard Scores,
Deviation IQ’s or Percentile Equivalents as a
Minimum) P9009, P9010)
P9001
Projective Personality Testing (Rorschach or
79.00
Other Appropriate Projective Measures)
(Do not use P9001 with P9006, P9007, P9008, P9009,
P9010) P9002
Objective Personality Testing (MMPI or Other
55.00
Appropriate Objective Measures)
(Do not use P9002 with P9006, P9007, P9008,
P9009, P9010) P9003
Standardized Academic Achievement Testing 39.00
(Do not use P9003 with P9006, P9007, P9008,
P9009, P9010) P9004
Standardized Vocational Interest Inventory 48.00
(Do not use P9004 with P9006, P9007, P9008,
P9009, P9010) P9005
Specific Aptitude Test; Minimum of Three Sub- 48.00
Tests (Purdue Pegboard, Differential Aptitude
Tests) P9006
General Psychological Test Battery to include 250.00
Clinical Interview; Intellectual, Vocational
Interest, Educational Skill, and Personality
Evaluations; and Written Report to include
Clinical Impressions, Diagnoses, Prognoses,
and Recommendations by Licensed
Psychologist
Review of General Psychological Test Battery
Results (P9006); Perceptual, Memory, and/or
Attentional Assessments; Diagnostic Achievement
Testing (e.g., Writing Sample, Reading
Comprehension); and Written Report with Clinical
Impressions, Diagnoses, Prognoses, and
Recommendations by Licensed Psychologist P9008
LD/ADD Test Battery to include Clinical Interview;
344.00
Intellectual, Vocational Interest, Educational Skills,
and Personality Evaluations; Perceptual Memory,
and/or Attentional Assessments; Diagnostic
Achievement Testing (e.g., Writing Sample, Reading
Comprehension); and Written Report with Clinical
Impressions, Diagnoses, Prognoses, and
Recommendations by Licensed Psychologist P9009
Neuropsychological Test Battery to include Clinical
431.00
Interview; Review of General Psychological Test
Battery Results (P9006); Evaluation of Sensori-
neural Factors (Halstead-Reitan, Luria Nebraska,
Boston, Lezak, or Equivalent Battery); and Written
Report with Clinical Impressions, Diagnoses,
Prognoses, and Recommendations by Licensed
Psychologist P9010
Neuropsychological Test Battery to include 625.00
General Psychological Test Battery (P9006);
Evaluation of Sensorineural Factors (Halstead-
Reitan, Luria Nebraska, Boston, Lezak, or
Equivalent Battery); and Written Report with
Clinical Impressions, Diagnoses, Prognoses,
and Recommendations by Licensed Psychologist P9011
Clinical Interview and Written Report with Clinical
94.00
Impressions, Diagnoses, Prognoses, and
Recommendations
Psychologist (Doctoral Degree)
(50 – 60 Minute Session)
(Cross Reference CPT Code 90806) P9013
Individual Therapy provided by Certified
67.00
Psychologist with Autonomous Functioning,
Licensed Clinical Social Worker,
Certified Psychologist (Requires
Supervision), Clinical
Nurse Specialist (Master’s); Advanced
Registered Nurse Practitioner with
Master’s in Mental Health or equivalent
to Master’s Certified Clinical Nurse Specialist
(50 – 60 Minute Session)
(Cross Reference CPT Code 90806) P9014 Individual Therapy billed by Supervising 67.00
Practitioner and provided by Licensed Psychological
Associate,
Licensed Social Worker, Certified Social
Worker, Licensed Professional Clinical Counselor,
Certified Professional Clinical Counselor, or
Licensed Marriage and Family Therapy
(50 – 60 Minute Session)
(Cross Reference CPT Code 90806) P9015
Group Therapy provided by Licensed Psychologist
31.00
(Doctoral Degree)
(50 – 60 Minute Session) P9016
Group Therapy provided by Certified
Psychologist
29.00
with Autonomous Functioning, Licensed Clinical
Social Worker, Certified Psychologist (Requires Supervision), Clinical Nurse Specialist (Master’s), Advanced Registered
Nurse Practitioner with Master’s in Mental
Health or Equivalent to Master’s Certified
Clinical
Nurse Specialist (50 – 60 Minute Session)
and provided by Licensed Psychological Associate,
Licensed Social Worker, Certified Social Worker,
Licensed Professional Clinical Counselor,
Certified Professional Clinical Counselor, or
Licensed Marriage and Family Therapist
(50 – 60 Minute Session) P9018
Psychological Session with Consumer
48.00 and
Counselor (30
Minute Session) or
Services performed in a Group Setting P9020
Central Office Level Consultation on Problem Case
70.00 (1 Hour)
MS-CE-01-02-16 DATE: May 17, 2002 Effective May 20, 2002.
Current Vocational Rehabilitation Federal Regulations indicate that diagnosis and treatment for mental and emotional disorders must be provided by qualified personnel in accordance with State licensure laws and regulations (i.e., a physician, licensed psychologist, or licensed clinical social worker (LCSW)). A certified psychologist and a psychological associate must be supervised by a licensed psychologist. Assessments, treatment plans, and progress reports must be countersigned by the supervising psychologist. A certified psychologist may direct bill this agency. A psychological associate may not direct bill, rather the supervising licensed psychologist must direct bill for DVR payment. A certified psychologist with autonomous functioning requires no supervision and may direct bill the agency. A licensed clinical social worker (LCSW) does not require supervision and may direct bill this agency. DVR will not cover psychological testing, Procedures P9000 through 9010, administered by a licensed clinical social worker (LCSW); however the diagnostic clinical interview, Procedure P9011, will be covered. A licensed social worker (LSW) and certified social worker (CSW) must be supervised by a psychiatrist, licensed psychologist, or licensed clinical social worker (LCSW) with all reports countersigned by the latter. The licensed or certified social worker may not direct bill; rather the supervising personnel must direct bill for DVR payment. Fees for psychological testing, Procedures P9000 through P9010, cover the clinical interview, administration of standardized tests, interpretation of test results, and written reporting of results with recommendations by the licensed psychologist. P9000 through P9005 are to be used only when a full battery of tests, i.e., P9006, P9007, P9008, P9009, and P9010, not indicated. Two Batteries, P9007 and P9008, cover assessment of Learning Disabilities and Attention Deficit Disorder. Battery P9007 involves review of the General Psychological Test Battery results (P9006) with the administration of additional LD/ADD assessments. Battery P9008 involves administration of the General Psychological Test Battery and the additional LD/ADD assessments. Relative Value Schedule, Medicine Section, Psychiatry Procedures 90801 through 90899 are not to be used when the vendor is a psychologist or social worker. These codes are to be used when the vendor is a psychiatrist.
PSYCHOLOGICAL FEE SCHEDULE ITEM NUMBER PSYCHOLOGICAL UNIT PRICE P9000 Full Scale Intelligence Testing(WAIS-R, $118.00 Stanford Binet, or Equivalent with Standard Scores, Deviation IQ’s or Percentile Equivalents as a Minimum) (Do not use P9000 with P9006, P9007, P9008, P9009,P9010)
P9001 Projective Personality Testing (Rorschach or 79.00 Other Appropriate Projective Measures) (Do not use P9001 with P9006, P9007, P9008, P9009, P9010)
P9002 Objective Personality Testing (MMPI or Other 55.00 Appropriate Objective Measures) (Do not use P9002with P9006, P9007, P9008, P9009, P9010)
P9003 Standardized Academic Achievement Testing 39.00 (Do not use P9003 with P9006, P9007, P9008, P9009, P9010)
P9004 Standardized Vocational Interest Inventory 48.00 (Do not use P9004 with P9006, P9007, P9008, P9009, P9010)
P9005 Specific Aptitude Test; Minimum of Three Sub- 48.00 Tests (Purdue Pegboard, Differential Aptitude Tests)
P9006 General Psychological Test Battery to include 250.00 Clinical Interview; Intellectual, Vocational Interest, Educational Skill, and Personality Evaluations; and Written Report to include Clinical Impressions, Diagnoses, Prognoses, and Recommendations by Licensed Psychologist
P9007 LD/ADD Test Battery to include Clinical Interview; $125.00 Review of General Psychological Test Battery Results (P9006); Perceptual, Memory, and/or Attentional Assessments; Diagnostic Achievement Testing (e.g., Writing Sample, Reading Comprehension); and Written Report with Clinical Impressions, Diagnoses, Prognoses, and Recommendations by Licensed Psychologist
P9008 LD/ADD Test Battery to include Clinical Interview; 344.00 Intellectual, Vocational Interest, Educational Skills, and Personality Evaluations; Perceptual Memory, and/or Attentional Assessments; Diagnostic Achievement Testing (e.g., Writing Sample, Reading Comprehension); and Written Report with Clinical Impressions, Diagnoses, Prognoses, and Recommendations by Licensed Psychologist
P9009 Neuropsychological Test Battery to include Clinical 431.00 Interview; Review of General Psychological Test Battery Results (P9006); Evaluation of Sensori- neural Factors (Halstead-Reitan, Luria Nebraska, Boston, Lezak, or Equivalent Battery); and Written Report with Clinical Impressions, Diagnoses, Prognoses, and Recommendations by Licensed Psychologist
P9010 Neuropsychological Test Battery to include 625.00 General Psychological Test Battery (P9006); Evaluation of Sensorineural Factors (Halstead- Reitan, Luria Nebraska, Boston, Lezak, or Equivalent Battery); and Written Report with Clinical Impressions, Diagnoses, Prognoses, and Recommendations by Licensed Psychologist
P9011 Clinical Interview and Written Report with Clinical 94.00 Impressions, Diagnoses, Prognoses, and Recommendations.
P9012 Individual Therapy Session provided by Licensed $ 79.00 Psychologist (Doctoral Degree) 50 – 60 Minute Session
P9013 Individual Therapy provided by Certified 63.00 Psychologist with Autonomous Functioning, licensed Clinical Social Worker (LCSW), Certified Psychologist, or Psychological Associate (Master’s Degree) 50 – 60 Minute Session
P9014 Group Therapy provided by Licensed Psychologist 31.00 (Doctoral Degree) (50 – 60 Minute Session)
P9015 Group Therapy provided by Certified Psychologist 29.00 with Autonomous Functioning, Licensed Clinical Social Worker (LCSW), Certified Psychologist, or Psychological Associate (Master’s Degree) 50 – 60 Minute Session
P9016 Psychological Session with Consumer 48.00
P9017 Psychological Services for Special Disability Group BR or Services performed in a Group Setting
P9018 Central Office Level Consultation on Problem Case 70.00 (1 Hour)
SERVICE FEE MEMORANDUM MS-94-95-24 (CORRECTED) DATE OF ORIGINATION: April 3, 1995 AMENDED DATE: May 1, 1995 RE: Psychological Fee Schedule Current Vocational Rehabilitation Federal Regulations indicate that diagnosis and treatment for mental and emotional disorders must be provided by qualified personnel in accordance with State Licensure laws and regulations (i.e. a physician, licensed psychologist, or licensed clinical social worker (LCSW)). A certified psychologist and a psychological associate must be supervised by a licensed psychologist. Assessments, treatment plans, and progress reports must be countersigned by the supervising psychologist. A certified psychologist may direct bill this agency. A psychological associate may not direct bill, rather the supervising licensed psychologist must direct bill for DVR payment. A certified psychologist with autonomous functioning requires no supervision and may direct bill the agency. A licensed clinical social worker (LCSW) does not require supervision and my direct bill this agency. DVR will not cover psychological testing, Procedures 9000 through 9007b, administered by a licensed clinical social worker (LCSW); however the diagnostic clinical interview, Procedure 9008, will be covered. A licensed social worker (LSW) and certified social worker (CWS) must be supervised by a psychiatrist, licensed psychologist, or licensed clinical social worker (CLSW) with all reports countersigned by the latter. The licensed or certified social worker may not direct bill; rather the supervising personnel must direct bill for DVR payment. Fees for psychological testing, Procedures 9000 through 9007b, cover the clinical interview, administration of standardized tests, interpretation of test results, and written reporting of results with recommendations by the licensed psychologist, 9000 through 9004 are to be used only when a full battery of tests, i.e. 9005, 9006a, 9006b, have been added. Battery 9006a involves review of the General Psychological Test Battery results (9005) with the administration of additional LD/ADD assessments. Battery 9006b involves administration of the General Test Battery and the additional LD/ADD assessments. Relative Value Schedule Codes 90701, 90842, 90843, and 90862 are not to be used when the provider is a psychologist or social worker. These codes are to be used only when the provider is a psychiatrist.
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