[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-501532-105":59,"doc-detail-501532-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","concussion-testing-policy","Concussion Testing - Policy","","Medical policy for Highmark Health Options Medicaid products defining coverage guidance for evaluation of suspected concussion. Prior authorization is not required. It outlines medically necessary noncomputerized cognitive and balance testing when used as an adjunct to clinical examination and diagnostic testing. It excludes computer-based neuropsychological testing and portable point-of-care devices as experimental/investigational due to insufficient published peer-reviewed evidence of safety and effectiveness. It also summarizes evidence-based sports concussion guideline updates addressing risk factors, diagnostic tools, and interventions.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/concussion-testing-policy/501532/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/concussion-testing-policy/501532.png","ImageObject",300,407,{"name":92,"@type":93},"Bulrr","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-10-03",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Is prior authorization required for concussion-related testing under this policy?","Question",{"text":112,"@type":113},"No. Prior authorization is not required.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Are computer-based neuropsychological tests covered for suspected concussion?",{"text":117,"@type":113},"No. Computer-based neuropsychological testing for concussion is considered experimental/investigational and is non-covered due to insufficient evidence of safety and/or effectiveness.",{"name":119,"@type":110,"acceptedAnswer":120},"When can noncomputerized cognitive and balance testing be considered medically necessary?",{"text":121,"@type":113},"Noncomputerized testing to assess cognitive and balance impairment may be medically necessary when administered as an adjunct to clinical examination and diagnostic testing.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},501532,1791046125,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},5909892115043,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Concussion Testing  \n\n| Policy ID: | HHO-DE-MP-1074 |\n| --- | --- |\n| Approved By: | Highmark Health Options – Market Leadership |\n| Provider Notice Date: | 12/15/2021; 05/01/2023 |\n| Original Effective Date: | 01/15/2022; 06/01/2023 |\n| Annual Approval Date: | 10/08/2021; 06/22/2022; 03/22/2023 |\n| Last Revision Date: | 10/08/2021 ; 06/22/2022; 03/22/2023 |\n| Products: | Medicaid |\n| Application: | All participating hospitals and providers |\n| Page Number(s): | 1 of 6 |\n\nDisclaimer  \nHighmark Health Options medical policy is intended to serve only as a general reference resource regarding coverage for the services described. This policy does not constitute medical advice and is not intended to govern or otherwise influence medical decisions.  \nPOLICY STATEMENT  \nHighmark Health Options may provide coverage under the medical-surgical benefits of the Company’s Medicaid products for medically necessary benefits.  \nThis policy is designed to address medical necessity guidelines that are appropriate for the majority of individuals with a particular disease, illness or condition. Each person’s unique clinical circumstances warrant individual consideration, based upon review of applicable medical records.  \nThe qualifications of the policy will meet the standards of the National Committee for Quality Assurance (NCQA) and the Delaware Department of Health and Social Services (DHSS) and all applicable state and federal regulations.  \nDEFINITIONS  \nConcussion – A traumatic brain injury that affects your brain function.  \nHighmark Health Options (HHO)– Managed care organization serving vulnerable populations that have complex needs and qualify for Medicaid. Highmark Health Options members include individuals and families with low income, expecting mothers, children, and people with disabilities. Members pay nothing to very little for their health coverage. Highmark Health Options currently services Delaware Medicaid: Delaware Healthy Children Program (DHCP) and Diamond State Health Plan Plus LTSS (DSHP Plus LTSS) members.  \nPOLICY POSITION  \nPrior authorization is not required.  \nVarious testing methods, both computerized and non-computerized, are available to evaluate brain function and manage health following suspected concussion.  \nComputer-based neuropsychological testing includes any instrument that utilizes a computer, digital tablet, handheld device, or other digital interface instead of a human examiner to administer, score, or interpret tests of brain function and related factors relevant to questions of neurologic health and illness such as concussion.  \nComputer-based neuropsychological testing for concussion, is considered experimental/investigational, and therefore, non-covered because the safety and/or effectiveness of this service cannot be established by the available published peer-reviewed literature, tests include but are not limited to:  \n• Immediate Post-Concussion Assessment Tool (ImPACT™); or  \n• C3 Logix; or  \n• Headminder’s Concussion Resolution Index (CRI); or  \n• Computerized Cognitive Assessment Tool (CCAT); or  \n• Concussion Vital Signs.  \nBaseline computerized neuropsychological testing is considered experimental/investigational forasymptomatic individuals at risk for brain injuries, and therefore, non-covered because the safety and/or effectiveness of this service cannot be established by the available published peer-reviewed literature.  \nPortable, noninvasive, point of care devices, which record and measure brain function, analyze and display brain electrical activity, such as BrainScope One, are considered experimental/investigational in the evaluation of individuals with suspected concussion, and therefore, noncovered because the safety and/or effectiveness of this service cannot be established by the available published peer-reviewed literature.  \nNoncomputerized testing to assess cognitive and balance impairment following suspected concussion (e.g. , Sport Concussion Assessment Tool [SCAT] and Balanc","cbCaijpUFbU316U2","https://ap.wps.com/l/cbCaijpUFbU316U2","pdf",127166,"English","# Policy Statement\n## Definitions\n## Policy Position\n## Professional Statements and Societal Positions Guidelines","[{\"question\":\"Is prior authorization required for concussion-related testing under this policy?\",\"answer\":\"No. Prior authorization is not required.\"},{\"question\":\"Are computer-based neuropsychological tests covered for suspected concussion?\",\"answer\":\"No. Computer-based neuropsychological testing for concussion is considered experimental/investigational and is non-covered due to insufficient evidence of safety and/or effectiveness.\"},{\"question\":\"When can noncomputerized cognitive and balance testing be considered medically necessary?\",\"answer\":\"Noncomputerized testing to assess cognitive and balance impairment may be medically necessary when administered as an adjunct to clinical examination and diagnostic testing.\"}]","Concussion Testing - Policy | PDF",1791020303,15]