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Neurofeedback CPT Insurance Codes
Is Neurofeedback covered by Insurance?
At the Neurofeedback Wellness Center, we are not on insurance panels and we don't file insurance paperwork for you. We supply receipts and documentation that will assist you with filing with your insurance provider. It's filled with the appropriate CPT codes for your sessions and you simply mail it in.
Our clients pay the Neurofeedback Wellness Center with credit cards, or checks. Sessions are often recorded as EEG Biofeedback (Neurofeedback) insurance code 90901 (although other codes on occasion are used). Sometimes insurance companies cover the codes and reimburse. However; with the ever changing Insurance industry, Insurance companies have become very good at denying reimbursement (that's not unique to neurofeedback.) We have been informed by some clients that by getting your family practitioner, MD, or psychiatrist to prescribe eeg-biofeedback (same as neurofeedback) or biofeedback and refer to our center (Neurofeedback Wellness Center)
that this will at least increases the odds of reimbursement. Some clients have gotten their sessions covered with United Health Care and Cigna using biofeedback. That doesn't mean everyone is approved.
It's been reported that most insurance companies are good at saying no, at least in the first submittal and those clients who are aggressive at appealing may increase the chances of reimbursement. Insurance policies vary from company to company and this includes which diagnosis codes they will reimburse for. It has been rumored that some individuals have attempted to contest claims by stating that the insurance companies are forcing the use of medications with significant side effects while denying research based treatments (such as neurofeedback) that has no side effects. We don't know how successful that is.
Why should you get a prescription or referral for biofeedback?
We find that by getting a doctors prescription for biofeedback, and through the fact that most insurance forms have special places for it. This simply maximizes the chances that you can be reimbursed. However, it's not required that you have a prescription and some insurance companies won't care if you have a doctor's prescription or not. We've included the main CPT code that we typically use to file is 90901 for biofeedback.
Neurofeedback vs. Medications
We are living in a society where the overuse of prescription drugs has reached an all time high. No matter how outrageous it may seem, there is a drug out on the market for just about every ailment known to man. Have a headache? Of course we have a prescription drug for that. Sexual dysfunction? We've got a little blue pill that will correct that problem too. Are you sad; lonely; hyper; anxious; tired; or not as endowed as you would like to be? You're in luck, we've got pills for that also.
Ironically, as the media constantly bombards us with information about what new drug they've come out with, the same drugs mass produced to alleviate the problem (or the symptoms) only cause a hundred more. So what do we do then? Do we take additional prescription drugs to counteract the side effects caused by the previous ones?
Well one option instead of giving you or your family medications, is the use of neurofeedback, a non-invasive, drug-free approach to rehabilitating brain function. Medications and neurofeedback are both successful in their own way. There are, however, significant differences in the ways these treatments work, the potential side effects of their use, and the length of treatment necessary. Some of the most commonly prescribed medications (i.e. for the use for ADD ADHD) are derived from some form of stimulant or antidepressant. Most of these medications carry the FDA'S "Black Box Warning" Labels, and should be used with caution. These warnings refer to the possibility of serious cardiovascular side effects, as well as the possible suppression of children's growth, and heightened risk for psychosis, bi-polar illness, and aggression. In addition to these problems, this class of medications is also associated with potential side effects as weight loss in children, over-stimulation of the central nervous system, dizziness, difficulty sleeping, tremors, headaches, and tics or Tourettes Syndrome.
Now, let's take a look at how these different treatments work. The medications contain artificial chemicals which increase neurotransmitter levels in the brain. This allows the brain to function better, thus treating the condition. As these chemicals are artificial, they may cause unfavorable reactions in the brain, and therefore, bring about the aforementioned negative side effects.
Neurofeedback trains the brain to function faster through a highly specialized type of exercise. As the brain learns to function faster, it naturally increases its production of neurotransmitters and the brain functions better, thus treating the condition. The end result is the same in both forms of treatment. with one very big difference. Neurofeedback does not introduce anything unnatural into the brain, but rather trains the brain to function better through its own natural mechanisms, so it produces no side effects. As vulnerable as children are, the last thing we want to do is expose them to these unnecessary dangers.
Finally, length of treatment is another big difference. Medication is only effective while it's in the bloodstream. Therefore, no amount of medication will ever produce a lasting effect. The medication must be continually taken to treat the condition, and this is often a lifelong process, with the continuing potential for these side effects.
Once neurofeedback treatment is completed, no further treatment is necessary. With neurofeedback, there are no side effects, and the treatment is a one-time process. Neurofeedback is an effective, drug free, painless procedure in which our clients learn to retrain the mechanisms of their brain, alleviating the condition.
Feel free to contact us if you have more questions.
| Alternate List of CPT Codes |
| 90901 | Biofeedback by any modality | * Primary Code to be used |
| 90876 | Individual psychophysiological therapy including biofeedback | |
| 90801 | Diagnostic Interview | |
| 96119 | Neuropsychological assessment by Technician | |
| 96103 | Neurofeedback assessment by computer - TOVA | QIKtest | |
| 95816 | Digital EEG recording | |
| 95957 | Digital EEG analysis | |
| 99090 |
Reference EEG database |
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| 95812 | EEG extended recording, 41-60 min | |
| Diagnostic / Diagnosis Codes |
The Neurofeedback Wellness Center does not diagnose (i.e. Label) and refers our clients to be independently tested or diagnosed by their family practitioner, psychologist, psychiatrists, or MD - should they chose to do so.
Our neurofeedback training protocols are generated through specific doctor's referrals, our individual client intake, cognitive and variable testing, including a 19 site EEG recording, and interpretation of the quantitative analysis through the use of a normative database.
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