CommercialCoverageHigh impact
Neuropsychological and Psychological Testing 3.01.24
Excellus BlueCross BlueShield·Psychiatry, Neurology, Family Medicine +2 more·Behavioral Health (Psychiatry/Psychology), Nervous Systems (Neurology)
Effective date
Apr 29, 2026
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield has updated their neuropsychological and psychological testing policy effective April 29, 2026, establishing specific medical necessity criteria including required comprehensive evaluations before testing and time limits for repeat testing. The policy details what conditions qualify for testing and excludes screening for asymptomatic individuals.
Action Required
Before April 29, 2026: Billing team must update pre-authorization requirements for neuropsychological and psychological testing claims. Ensure documentation includes comprehensive evaluation, mental status exam, medical history, and specific clinical indications from the approved list. Update encounter forms to capture required elements including referral questions, proposed test battery, estimated testing time, and treatment plan impact. Train providers on 2-year repeat testing restrictions and 3-6 month standard care requirements for certain conditions.