This presentation will focus on recent developments in CPT coding and insurance reimbursement for neurofeedback and QEEG. The topics covered will include: history of CPT codes to date, proposed changes to current CPT codes with rationale, modifiers for CPT codes (non-covered service, telehealth, etc) and the importance in using them, an update on insurance reimbursement (both coverage and rates), the relevance of scope of practice and state licensure, and an update on major legal wins with mental health parity that could have a profound effect on getting neurofeedback reimbursed. Two other topics will be covered: how do we advocate for ourselves moving forward on CPT coding and insurance reimbursement and what can individuals and their practices do to help with this process.
This presentation will utilize information from the presubmission version of ISNR’s AMA CPT CCA from 2020 and will review information that can be shared publicly regarding the application and discuss the collaborative effort. This will demonstrate the attempt to include all forms of EEG Neuorfeedback in the application and it is an avenue for increased reimbursement rates and coverage. The goal of this part of the presentation will be education to correct misinformation regarding the applications for CPT code changes and the goals. It will also be used to educate on what actually happens in the process and the difficulties with trying to meet some of the more challenging requirements of a code change application.
The presentation will reinforce the importance of the CPT code change and why it is relevant for ISNR membership in the U.S. and internationally. The membership will be informed of how to obtain support and troubleshooting with CPT coding and reimbursement issues, and using mental health parity for appeals when appropriate. These strategies and proposed timelines for various next steps in the process will be covered.
Presented by: Mark Trullinger