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NC Medicaid Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans will launch July 1, 2024. Choice period ends on May 15, 2024. Please call to select your PCP. Find PCPs available in our health plan.

Effective February 1, 2024, citizens of Harnett County are being served by Alliance Health. Access more information for health plan participants or for providers.

Alliance Health
Provider Support: 855-759-9700
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Medicaid B: Psychological Testing

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About

Coverage Information Icon

Medicaid Direct (Medicaid B)

Diagnosis Group(s) Information Icon

Developmental Disability, Mental Health, Substance Use

Age Group(s) Information Icon

18-20, Adults 18+, All, Child

Reference Documents

Authorization

Submission Requirements Information Icon

  • 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 Information Icon

  • 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

Request Prior Approval from Alliance Health

Service Codes & Descriptions

  • 96130 Psychological testing evaluation
  • 96130 GT- Psychological testing evaluation
  • 96136 Psychological or Neuropsychological test administration first 30 minutes
  • 96146 Automated instrument psych/neuro test administration
  • 918 - Psychiatric/Psychological Svcs: Testing

Full Service Definition

<a target="_blank" href="https://medicaid.ncdhhs.gov/8c-outpatient-behavioral-health-services-provided-direct-enrolled-providers/download?attachment">Download PDF</a>
Download PDF

Alliance Provider Support is available to answer provider questions about authorization, billing, claims, enrollment, ACS, or other issues.

Call 855-759-9700 Monday-Saturday from 7:00am-6:00pm.