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Contractor Information

Contractor Name: Wisconsin Physicians Service Insurance Corporation - Full list of policies of this Medicare Contractor Contractor Number: 05301 Contractor Type: MAC A

LCD Information

LCD ID Number: L34646 Status: A-Approved LCD Title: Psychological and Neuropsychological Testing Geographic Jurisdiction: Missouri - Entire State Other Jurisdictions Original Determination Effective Date: 10/01/2015 Original Determination Ending Date: Revision Effective Date: 10/31/2024 Revision End Date: CMS National Coverage Policy: Social Security Act 1861(s) Medical And Other Health Services Social Security Act 1862(a)(7) does not extend coverage to screening procedures. 42 CFR (Code of Federal Regulations): 410.73 Clinical social worker services 410.74 Physician assistants’ services 410.75 Nurse practitioners’ services 410.76 Clinical nurse specialists’ services MLN Matters Number SE0441 “Incident to” Services. CMS Publication 100-02: Medicare Benefit Policy Manual, Chapter 15 - Covered Medical and Other Health Services: §80.2 Psychological and Neuropsychological Tests §160 Clinical Psychological Services §170 Clinical Social Worker (CSW) Services §210 Clinical Nurse Specialist (CNS) Services CMS Publication 100-03: Medicare National Coverage Determinations (NCD)Manual, Chapter 1- Coverage Determination, Part 1, Sections 10-80: §30.1 Biofeedback Therapy CMS Publication 100-04: Medicare Claims Processing Manual, Chapter 12 - Physicians/Nonphysician Practitioners: §120 Nurse Practitioner (NP) and Clinical Nurse Specialist (CNS) Services Payment Methodology §120.1 Limitations for Assistant-at-Surgery Services Furnished by Nurse Practitioners and Clinical Nurse Specialist §150 Clinical Social Worker (CSW) Services §160 Independent Psychologist Services §170 Clinical Psychologist Services §170.1 Payment Sorry, you need to login or register to view additional sections of this Medicare policy. *