IS BIO/NEUROFEEDBACK COVERED BY INSURANCE?

Some medical and psychological insurance plans now cover neurofeedback and/or biofeedback for various conditions. Reimbursement to the client varies by carrier and by plan. Check with your insurance company about coverage for biofeedback. Neurofeedback is a form of biofeedback, and is billed as biofeedback.

  • Be sure you understand what your insurance policy will cover, and for which diagnoses.

  • Important: If you are told that biofeedback is covered, be certain to document the name of the insurance representative, with whom you spoke, the date and time of your conversation. This information will be needed in the event of any misunderstandings regarding coverage or any reimbursement refusals by your insurance carrier. We have experienced instances when a representative had assured a client that biofeedback would be covered, but later the insurance company refused to reimburse the client. If you have documented your conversation, you are more likely to win an appeal.

You may ask your insurance carrier about coverage for specific CPT (Current Procedure Terminology) codes. We use one or more of the following codes for Neurofeedback services:

INITIAL CONSULTATION: 90837 or 90832

Some insurance companies reimburse one code preferentially. This code is used for counseling sessions as well.

INTAKE INTERVIEW: 90791

Can be used for the first 1-8 visits to assess, diagnose, or treatment planning. During the intake, you will complete symptom scales and other assessments.

BIOFEEDBACK AND NEUROFEEDBACK: 90901 or  96158 &96159

  • 90901 is used for psychological disorders, such as: Anxiety, Depression, Post Traumatic Stress Disorder and Attention Deficit Disorder

  • 96158/96159 97129/97130 Health/ Behavioral Intervention, is used only for medical diagnoses such as:

    • F51.01 – Primary Insomnia

    • G44.209 – Tension-Type Headache

    • G43.911 – Migraine

    • F07.81 – Post Concussion Syndrome

    • G44.329 – Chronic post-traumatic headache

    • S06.0X0A – Concussion w/o loss of consciousness

    • I73.00 – Raynaud’s

    • K59.00 – Constipation

    • H93.1 -Tinnitus

    • K58.9 – Irritable Bowel Syndrome

  • 97129/97130 Therapeutic interventions that focus on cognitive function (e.g., attention, memory, reasoning, executive function, problem-solving and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (e.g., managing time or schedules, initiating, organizing and sequencing tasks.

Other questions you might ask your health insurance company:

Is biofeedback a covered benefit under my insurance policy? _______

– If the answer is yes, then:

  1. Is it covered under a. Medical Services? ____ b. Psychological Services? ____

  2. For which diagnosis is it covered? __________

  3. Under which code is it covered? a. 90901 ____ b. 96152 ____

  4. Do I need a prescription or letter from my medical doctor to say that it is medically necessary?

  5. Do I need a referral from my primary care physician? ____

  6. Will I need preauthorization? _____ If so, what is the preauthorization code? ____

  7. How many sessions are allowed? ____ a. Per week? ____ b. Per year?____ c. Is there a dollar amount limit? ____

  8. Is there a deductible? a. If so, what is it? ____ b. If so, how much of the deductible has been met? ______

  9. Is there a co pay? _______ If so, what is it? _____

  10. If biofeedback is covered, can counseling (90837, 90834 or 90832) be billed on the same day?

  11. Is there a limit to the total amount the insurance company will reimburse each year? Is there an annual benefits cap that could affect the amount of my reimbursement?

LENS Neurofeedback

What is LENS Neurofeedback?

The Low Energy Neurofeedback System (LENS) is an EEG based, direct neurofeedback system that stimulates the brain to reset itself and achieve optimal performance. Addressing the brain in its own electromagnetic language, LENS allows the brain to “reboot,” restoring optimal functioning.

Who Can LENS Therapy Help?

LENS therapy can help any one of any age struggling with neurological issues, mental health, performance, sleep, cognitive and emotional issues and aliments of any kind. Clients with traumatic brain injuries have experienced relief from symptoms quickly and permanently. Clinical studies support the effectiveness of LENS, as well as the results of over 75,000 people who have already been treated. Doctors and researchers recommend LENS for adults, teens and children suffering from:

ADD/ADHD

Addiction

Anxiety

Autism and Asperger’s

Depression

Head Injury

Neurological Issues

Panic Attacks

Chronic Pain, Bodily Pain, Pain from Injury

Post-Partum Depression

Sensory Processing Difficulties

OCD

Trauma/Post Traumatic Stress Disorder

Sleep Problems

Suicide/Suicidal Ideation

Vertigo/Dizziness/Balance Problems

Will Rickman, Neurofeedback Technician

Katherine Poole, Neurofeedback Technician

Neurofeedback is a stand-alone treatment and can be done 1-3 times per week. To get started with neurofeedback, you can call or text or office at 901-930-7397. You can additionally reach out via email to officemanager@forwardcounseling.com.

Self-pay is the quickest and easiest way to access Neurofeedback services. Under certain conditions, Insurance will cover Neurofeedback. If you want to use insurance for neurofeedback, make sure you let the intake team know when you are booking. Also, please follow the steps above and bring the information with you to your appointment.