Psychological Testing

Records from current and prior treating and evaluation sources should be obtained prior to ordering new psychological evaluations. As a general policy, the more extensive the treatment history, the less in-depth psychological evaluations are needed. If questions arise regarding the adequacy of the records or the need for further psychological evaluation, when feasible counselors and Program Administrators are encouraged to secure input from their District Psychological Consultant or the State Psychological Consultant.

With each referral for psychological evaluation, there must be documentation of the referral questions and rationale for the referral. Referral questions may typically appear in a referral letter to the psychologist whereas the rationale for the referral may only appear in the case record narrative. Referral questions and the rationale statement could also be included in the referral letter to the evaluating psychologist.

All reports must include the following information:

1. Date the testing was administered.
2. Who administered the testing.
3. Person who interpreted the testing and wrote the report submitted.
4. Time spent administering each test.
5. The total time spent on interpretation and reporting.

The following are psychological evaluation guidelines. Also included are common reasons for authorizing these procedures and maximum charges that are allowed. Individual psychologists may substitute their own preferred assessments to address the counselor’s referral questions provided the billing does not exceed the following guidelines or a maximum of 6 hours (up to a maximum of $117 per hour).

Mental status examination

• This is a clinical interview to confirm functional limitations for persons with a history of mental illness. This also may be used as an initial examination for clients who have reported work problems or presented unusual behavior during the initial interview with the counselor. If the mental status exam results indicate intellectual and personality assessments are needed, then additional evaluations would be authorized. This level of examination may be sufficient for rehabilitation facility referrals which need a current assessment of an already diagnosed disability. The mental status examination is an appropriate evaluation when the client’s impairments appear overtly severe and when there is extensive but not current treatment history.

Intelligence testing up to a maximum of 2.5 hours

• This includes the Weschler Adult Intelligence Scale-Revised and the Stanford-Binet. It will not require the same amount of time to administer this testing to all vocational rehabilitation (VR) clients. In particular, clients with a diagnosis of mental retardation typically require much less time to administer this testing. Intellectual testing should only be ordered if there is a reason to suspect an intellectual deficit or learning disability. Intellectual testing may also be appropriate when a client is interested in pursuing an academic or training program that requires a certain level of cognitive ability; however, other sources of functional information such as school transcripts and prior work history should be utilized before ordering intellectual testing. IQ testing done after the age of 16 is considered to be stable throughout a person’s adult life, assuming the original testing was a valid and reliable estimate and there were no intervening injuries or disease process that could result in a decline in cognitive functioning.

Standardized Achievement Testing up to a maximum of 2.5 hours

• In cases where a learning disability is suspected, the Woodcock-Johnson Achievement Battery is recommended. When achievement deficits are believed to result from academic underachievement or lack of education, the Wide Range Achievement Test may be sufficient (maximum of 1 hour).

Personality Assessment up to a maximum of 1 hour per test or 2 hours

• In situations where there is reason to suspect that a psychiatric impairment will interfere with work function or completion of a training or academic program, personality assessment such as the MMPI (1 hour) and/or projective testing such as the Rorschach or TAT (1 hour each) may be appropriate, particularly if there is a minimum of existing information.

Substance Abuse

• If substance abuse is an issue, it should not be evaluated with the use of psychological evaluation. Instead, the client should be referred to Kansas Department for Children and Families (DCF) Alcohol and Drug Abuse Services for an assessment.

Neuropsychological assessment up to a maximumof 8 hours

• Neuropsychological evaluation (such as the Halstead Reitan and Luria Nebraska) should be done very sparingly but may be appropriate in complex cases of head injury or learning disability. The District or State Psychological Consultant must approve referrals for a complete neuropsychological battery. The hourly rate is procedure code M0601 or 90830. This is not a specialist exam.