The use, education, training and supervision of neuropsychological test technicians (psychometrists) in clinical practice

In common with the practice of physicians and other health care providers, clinical neuropsychologists often employ clinical extenders. The use of technicians in neuropsychology has been reported as far back as the late 1930s (De Luca, 1989). By 1989 (Division 40, 1989 and 1991), there was clear evidence that a large percentage of North American clinical neuropsychologists involved technicians in their assessments. Consequently, the Division of Clinical Neuropsychology of the American Psychological Association developed recommendations for the education, training and supervision of non-doctoral personnel to be used in this capacity. In keeping with evolving national standards of clinical practice, the National Academy of Neuropsychology proposed, on May 15, 1999, that “technicians, psychometrists, psychometricians and psychological assistants” can, in a supervised setting, administer neuropsychological tests as well as related psychological and behavioral instruments (NAN Policy and Planning Committee, 2000). Further, the Veterans Administration (DM & S Supplement, MP-5, Part I, Authority: 38 US U.S.C. 4105, Appendix 17A, change 43) outlined the qualifications, supervision and duties of a “psychology technician” (GS 181-5/7/9). Thus, the two major organizations representing clinical neuropsychologists in the United States and the largest single organization employing technicians have acknowledged the use of and published standards involving technicians. By 2000, a majority of neuropsychologists were employing non-doctoral and/or non-licensed technical personnel. An empirical survey of neuropsychological practice standards in North America published in 2002 revealed that 51.2% of the over 1300 respondents indicated that they employed technicians (Sweet, Peck, Abramowitz, & Etzweiler, 2002). In 2006, the American Medical Association in conjunction with the United States’ Center for Medicare and Medicaid Services (CMS) published a series of new professional codes that more explicitly describe the administration, scoring and interpretation of neuropsychological instruments. One code (96118) is devoted strictly to the administration, scoring and/or interpretation of neuropsychological tests by an independently licensed psychologist (and, if insurance is filed, that psychologist must have a contractual arrangement with the respective reimbursement company or agency).