Tele-Neuropsychology: From Science to Policy to Practice

Scott A Sperling; Shawn K Acheson; Joshua Fox-Fuller; Mary K Colvin; Lana Harder; C Munro Cullum; John J Randolph; Kirstine R Carter; Patricia Espe-Pfeifer; Laura H Lacritz; Peter A Arnett; Stephen R Gillaspy

doi:10.1093/arclin/acad066

Tele-Neuropsychology: From Science to Policy to Practice

Arch Clin Neuropsychol. 2024 Feb 19;39(2):227-248. doi: 10.1093/arclin/acad066.

Authors

Scott A Sperling¹, Shawn K Acheson², Joshua Fox-Fuller^{3

4}, Mary K Colvin^{3

5}, Lana Harder^{6

7

8}, C Munro Cullum^{7

8

9}, John J Randolph^{10

11}, Kirstine R Carter¹², Patricia Espe-Pfeifer¹³, Laura H Lacritz^{7

8}, Peter A Arnett¹⁴, Stephen R Gillaspy¹⁵

Affiliations

¹ Department of Neurology, Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH, USA.
² Acheson Forensic NeuroPsyche Consulting, Asheville, NC, USA.
³ Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
⁴ Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA.
⁵ Harvard Medical School, Boston, MA, USA.
⁶ Children's Health, Children's Medical Center, Dallas, TX, USA.
⁷ Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
⁸ Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
⁹ Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
¹⁰ Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
¹¹ Randolph Neuropsychology Associates, PLLC, Lebanon, NH, USA.
¹² South Texas Veterans Health Care System, San Antonio, TX, USA.
¹³ Department of Psychiatry and Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
¹⁴ Department of Psychology, The Pennsylvania State University, State College, PA, USA.
¹⁵ American Psychological Association, Washington, DC, USA.

PMID: 37715508
DOI: 10.1093/arclin/acad066

Abstract

Objective: The primary aim of this paper is to accelerate the number of randomized experimental studies of the reliability and validity in-home tele-neuropsychological testing (tele-np-t).

Method: We conducted a critical review of the tele-neuropsychology literature. We discuss this research in the context of the United States' public and private healthcare payer systems, including the Centers for Medicare & Medicaid Services (CMS) and Current Procedural Terminology (CPT) coding system's telehealth lists, and existing disparities in healthcare access.

Results: The number of tele-np publications has been stagnant since the onset of the COVID-19 pandemic. There are less published experimental studies of tele-neuropsychology (tele-np), and particularly in-home tele-np-t, than other tele-np publications. There is strong foundational evidence of the acceptability, feasibility, and reliability of tele-np-t, but relatively few studies of the reliability and validity of in-home tele-np-t using randomization methodology.

Conclusions: More studies of the reliability and validity of in-home tele-np-t using randomization methodology are necessary to support inclusion of tele-np-t codes on the CMS and CPT telehealth lists, and subsequently, the integration and delivery of in-home tele-np-t services across providers and institutions. These actions are needed to maintain equitable reimbursement of in-home tele-np-t services and address the widespread disparities in healthcare access.

Keywords: Billing and reimbursement; Current procedural terminology; Health disparities; Healthcare access; Tele-neuropsychology; Telehealth.

Publication types

Review

MeSH terms

Aged
Humans
Medicare
Neuropsychological Tests
Neuropsychology* / methods
Pandemics*
Policy
Reproducibility of Results
United States