If you’d like to use your health insurance benefits to help cover the cost of a neuropsychological evaluation, follow these steps to check whether your plan includes out-of-network coverage:

Step 1: Call the Member Services Number

• Look on the back of your insurance card for the Member Services or Customer Service phone number.

• Call this number and let them know you’re inquiring about out-of-network benefits.

Step 2: Provide Key Information

• Tell the representative you are seeking a neuropsychological evaluation and want to know if your plan offers out-of-network coverage for this service.

• Be ready to provide the following details:

  • CPT Codes: Ask about coverage for these commonly used testing codes:

    • 96116 (Neurobehavioral status exam – clinical interview)

    • 96136 and 96137 (Test administration and scoring)

    • 96132 and 96133 (Test interpretation and feedback)

  • Diagnosis Code: If you have a referral or prior diagnosis, you may be asked for an ICD-10 code (your provider can assist with this).

Step 3: Ask These Questions

• “Do I have out-of-network benefits for outpatient neuropsychological testing?”

• “Is pre-authorization or a referral required?”

• “What is my deductible, and how much has been met this year?”

• “What percentage of the allowed amount is reimbursed for out-of-network services?”

• “Is there a maximum allowable amount for neuropsychological testing?”

• “What documentation is required to submit for reimbursement?”

Step 4: Submit for Reimbursement (If Eligible)

• If you have out-of-network benefits, you will typically pay the full fee up front to Beacon Light Neuropsychology.

• After the feedback appointment, we will provide a superbill (detailed receipt) containing all necessary codes and information for you to submit to your insurance company for potential reimbursement. Please note that we are happy to provide a superbill, but we do not directly contact insurance companies.