Skip to main content

Global Search

Use the search function below to search AllianceHealthPlan.org

Medicaid B - Developmental Testing (Extended)

Back to Services

About

Coverage

Medicaid B

Diagnosis Group(s)

Developmental Disability, Mental Health, Substance Use

Age Group(s)

18-20, Adult, All, Child

Reference Documents

Authorization

Submission Requirements

  • Service Authorization Request (SAR) required when over unmanaged visits
  • Requests for any psychological testing requires that a list of test(s) to be administered be included with the request

Service Definition Authorization Parameters

  • Unmanaged benefit up to 16 units per fiscal year/Billing maximum of 5 units daily
  • Unmanaged benefit Includes any combination of the following codes:  96112, 96113, 96116, 96121, 96130, 96131, 96132, 96133, 96136, 96137, 96146

COVID Prior Approval Flexibility:

  • Waive Prior Approval for Initial and Concurrent Requests

Service Codes & Descriptions

  • 96112 Developmental test administration first hour
  • 96112 GT CRDevelopmental test administration first hour

Full Service Definition

<a target="_blank" href="https://medicaid.ncdhhs.gov/media/10107/open">Download PDF</a>