Medi-Cal (Anthem Blue Cross plan forms) psychological testing coverage: codes, limits and prior authorization
The short answerPer Anthem Blue Cross's Medi-Cal managed care forms (February 2026), neuropsychological and autism spectrum disorder testing each need their own prior authorization request. The autism testing form allows one unit maximum of 96130, 96136 and 96138.
By Javier Alvarez · Updated · 1 min read
1 row: Medicaid (by state) · California. Public policy, not the member's benefits.
Medi-Cal (Anthem Blue Cross plan forms)
Anthem Blue Cross Medi-Cal Managed Care authorization forms, February 2026 · California
| 96130 | Limited (on Anthem Medi-Cal's autism spectrum disorder testing authorization form (one unit maximum)) [1] |
|---|---|
| 96131 | Limited (on Anthem Medi-Cal's autism spectrum disorder testing authorization form) [1] |
| 96132 | Limited (on Anthem Medi-Cal's neuropsychological testing authorization form) [2] |
| 96133 | Limited (on Anthem Medi-Cal's neuropsychological testing authorization form) [2] |
| 96136 | Limited (on Anthem Medi-Cal's autism spectrum disorder testing authorization form (one unit maximum)) [1] |
| 96137 | Limited (on Anthem Medi-Cal's autism spectrum disorder testing authorization form) [1] |
| 96138 | Limited (on Anthem Medi-Cal's autism spectrum disorder testing authorization form (one unit maximum)) [1] |
| 96139 | Limited (on Anthem Medi-Cal's autism spectrum disorder testing authorization form) [1] |
| Diagnoses | For neuropsychological testing, Anthem says it may be medically necessary with a cognitive or behavioral impairment related to a known or suspected medical or neurological condition, and testing must impact medical treatment planning. [2] |
| Visit limits | Anthem says neuropsychological assessment is not considered medically necessary for behavioral disorders, including ADHD. [2] |
| Prior authorization | Anthem Blue Cross (Medi-Cal Managed Care) asks that its autism testing form be submitted through Availity Essentials before services are rendered. Neuropsychological testing has its own form. [1] |
| Also | The autism testing form says psychologists should complete a diagnostic interview and screening measures first, and that placement, disability and forensic requests are not covered. Forms are dated February 2026 and apply to one plan, not all of Medi-Cal. [1] |
What Medi-Cal (Anthem Blue Cross plan forms)'s documents say
The table above has every field we found for Medi-Cal (Anthem Blue Cross plan forms), with numbered sources. In short:
- Prior authorization. Anthem Blue Cross (Medi-Cal Managed Care) asks that its autism testing form be submitted through Availity Essentials before services are rendered. Neuropsychological testing has its own form.
- Visit limits. Anthem says neuropsychological assessment is not considered medically necessary for behavioral disorders, including ADHD.
- Codes. 96130, 96131, 96132, 96133, 96136, 96137, 96138 and 96139 are limited.
Check Medi-Cal (Anthem Blue Cross plan forms)'s claim against the row
Before the claim goes out, compare it with the row above: the evaluation and administration codes pair the way the policy says, the hours fit any cap, the referral question is documented, and prior authorization covers the units. The psychological testing table compares Medi-Cal (Anthem Blue Cross managed care) with every other payer we checked.