Issue #25-01

The purpose of this Alert is to notify SSHSP providers that the SSHSP Current Procedural Terminology (CPT) Codes (also known as Handout 5) have been updated and must be used for Medicaid claiming on and after March 1, 2025. A few CPT codes have been updated but there are – no changes to the payment rates.

Handout 5 includes updated CPT codes and descriptions for the following three rate codes for psychological evaluation services:
Rate code 2002 changed from CPT code 96101 to 96130
Psychological testing evaluation services by physician or other qualified healthcare professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, family member or caregiver.
Rate code 2005 changed from CPT code 96111 to 96112
Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory, and/or other qualified health care professional, with interpretation and report.
Rate code 2007 changed from to CPT code 96118 to 96132
Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report and interactive feedback to the patient, family member(s) or caregiver(s).

The new Handout 5 is attached to this Alert and is also available online at: https://www.oms.nysed.gov/medicaid/training_materials/.

If you have any questions or comments regarding this Alert, please contact the NYS Department of Health at (518) 473-2160 or at SSHSP@health.ny.gov, the NYS Education Department, Medicaid Unit at medined@nysed.gov.