Anthem Blue Cross Blue Shield Requirements

Neuropsychological testing, also known as psychometric testing, is a comprehensive evaluation of cognitive, motor, and behavioral functional abilities related to developmental, degenerative, and acquired brain disorders. This testing may be used to augment a comprehensive medical history and physical examination, as well as a neurological investigation of certain conditions. Neuropsychological testing is considered medically necessary when there is evidence to suggest that the test results will have a timely and direct impact on the member’s treatment plan for certain indications. Repeat testing to track the status of an illness or the recovery progress is subject to individual case consideration but is generally not warranted.

· Traumatic brain injury

· Encephalitis

· Epilepsy and cognitive impairment suspected or documented

· Multiple sclerosis and suspected or demonstrated cognitive impairment

· Anoxic/hypoxic brain injury

· Cerebrovascular accident (CVA)

· Psychosis

· Major affect disorder

· History of intracranial surgery

· Brain tumor in remission or with slow progression

· Neurosurgery planned for epilepsy control

· Head injury with loss of consciousness

· Confirmed neurotoxin exposure

· Suspected dementia

Please contact Anthem Blue Cross Blue Shield if you have any questions.

Click here to download and print the request for authorization: neuropsychological testing form from Anthem for your referring physician to complete.