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Does BCBS Cover Psychological Testing in Tennessee?

Does BCBS Cover Psychological Testing in Tennessee?

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Does Blue Cross Blue Shield Cover Psychological Testing?

Yes, most Blue Cross Blue Shield insurance company health plans cover psychological testing. BCBS coverage for psychological testing depends on your specific insurance plan. Most plans may require a referral from your primary care physician and for you to fulfill your deductible, pay a co-pay, or pay co-insurance for the evaluation.

Insurance may be able to help cover the cost of psychological testing. Find out if your insurance provider can help with the costs by filling in our confidential insurance verification form below.

Examples of Psychological Tests & Assessments

Psychological evaluation and testing are comparable to medical examination in many aspects.

To determine what is causing a patient’s physical complaints, a primary care physician may request blood work or X-rays. The test results will be used to establish a treatment strategy.1 Psychological testing has the same function. Experienced psychologists monitor and watch a patient’s behavior using tests and other assessment instruments to determine a diagnosis and the proper treatment.

A psychological evaluation includes tests and assessments, two distinct but linked parts. Psychologists use both kinds of tools when developing a diagnosis and a treatment strategy. Examples of psychological tests and assessments include, but are not limited to:

  • Minnesota Multiphasic Personality Inventory (MMPI-2): The MMPI-2 is the most used psychometric exam in the world for assessing conditions of the mind that are associated with psychopathology.2
  • Beck Anxiety Inventory: This inventory is a quick self-report exam intended to gauge how severe an anxiety disorder’s symptoms are. It offers detailed scoring to aid practitioners in determining if a client’s anxiety symptoms are mild and manageable or severe and incapacitating.
  • Beck Depression Inventory: This 21-item inventory includes detailed scoring information to show if depressive symptoms are severe or within a normal range.
  • Clinical Interview: A psychologist can study a patient’s thoughts, reasoning, and interpersonal interactions as they talk to them about their problems and past.
  • Questionnaires/Checklists: These tests are frequently referred to as “norm-referenced.” Simply put, the examinations have been standardized to ensure that test-takers are assessed uniformly regardless of where they live or who administers the test.
  • Review of school and medical records: A psychologist can get a complete picture of a patient’s strengths and weaknesses by reviewing specific records.
  • Interviews with the patient’s family members, close friends, colleagues, etc.: Assessments may include speaking with people close to the patient.

Coverage Process & Forms

Most plans require a referral from your primary care physician for non-emergent services.3 BCBS insurance coverage for psychological testing is no different, though this depends on your specific health plan. For example, commercial PPO plans do not require prior authorization.

During prior authorization, it’s essential to deem psychological testing medically necessary to make a conclusive diagnosis. Tests of basic intellectual, cognitive, academic, motor, psychomotor, and developmental functions are frequently seen as educational.4 Psychological evaluations are not medically necessary for educational or employment purposes, nor if testing has been done in the past twelve months. However, in some circumstances, a repeat test after six to 12 months may be clinically necessary.

The prior authorization form for psychological testing in Tennessee is a 508C.5 It includes everything from basic patient information to a list of medications and any current diagnoses.

An 8-hour course is standard for psychological testing examination, administration, scoring, and interpretation. By presenting supporting documents, additional testing evaluation hours can be requested. Only when other complicating circumstances, such as hearing or vision impairment, should testing last longer than eight hours.

Tools, Goals & On-Going Treatment

Tools used in the field of behavioral health that are commonly acknowledged include psychometric instruments, inventories, surveys, and questionnaires.6 They are widely utilized in patient care, quality assessment, psychological testing, and primary and clinical research.

Psychological testing aims to produce conclusive diagnoses of psychiatric problems and recommendations to assist clients in recognizing their strengths and shortcomings. In addition, the testing suggestions serve as a road map for therapy treatment.

Psychologists who administer tests follow up with psychotherapy frequently. Some only concentrate on diagnosing their patients and then refer them to other medical professionals for treatment.

Athena Care is in-network with most major insurance plans. Filling out our free and confidential online insurance verification form is the best way to determine the specifics of your Blue Cross Blue Shield coverage for mental health assessments.

Allow our highly experienced, expert care coordinators to obtain more information for you. After completing the form, a care coordinator at one of our multiple mental health clinics in Tennessee will review your insurance policy and clearly explain your options for BCBS coverage for mental health testing. Rest assured, all submitted or discussed information will remain confidential.

Sources

  1. Eabon, Michelle F. PhD, and Dan PhD Abrahamson. “Understanding Psychological Testing and Assessment.” American Psychological Association, 10 Nov. 2013, www.apa.org/topics/testing-assessment-measurement/understanding.
  2. Celestine, Nicole, PhD. “12 Most Reliable Mental Health Assessment Tools.” PositivePsychology.com, 13 July 2022, positivepsychology.com/assessment-tools.
  3. BlueCross BlueShield of Tennessee, Inc. “2022 Member Handbook.” TN.gov, 2022, www.tn.gov/content/dam/tn/finance/fa-benefits/documents/blue_handbook_2022.pdf.
  4. BlueCare Plus Tennessee. “Psychological Testing Authorization Request Form.” Blue Cross Blue Shield of Tennessee, bluecareplus.bcbst.com/docs/providers/BlueCarePlus.pdf. Accessed 8 Oct. 2022.
  5. BlueCross BlueShield of Tennessee, Inc. “Psychological/Neuropsychological Testing Form.” Blue Cross Blue Shield of Tennessee, bluecare.bcbst.com/forms/Provider%20Forms/Psychological_Testing_Form.pdf. Accessed 8 Oct. 2022.
  6. Ranallo, Piper A et al. “Psychological assessment instruments: a coverage analysis using SNOMED CT, LOINC and QS terminology.” AMIA … Annual Symposium proceedings. AMIA Symposium vol. 2013 1333-40. 16 Nov. 2013. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3900148/.

If you suspect that you or someone you love suffers from mental health disorders, contact Athena Care today.

One of our friendly associates will help you get the help you need. Take this first step to feel better and take control. 

(615) 320-1155