REFERRING PROVIDERS:


If You Are Looking to Refer

a NEW Patient for

a Neurological CONSULT OR DIAGNOSTIC TEST, We Can Help.

For Referring Providers / Diagnostics / Workers’ Comp Referrals:

  • Download our 2026 New Patient Referral Form below, and include all Demos / Prior-Auth / CPT Codes for treatment requested / Medical History — and fax the complete packet to our Main Office at (209) 521-5204.
  • We do not accept Out-Of-Network Referrals at this time - It is important to contact your patient’s insurance to verify if patient is IN-NETWORK to prevent any delays in reviewing of the referral.
  • We currently do not accept IME Requests. Law Firms can contact our office with further questions.
2026 New Patient Provider Referral Form
  • Most Frequent CPT Codes that Need Prior-Auths:
  • NEW PATIENT OFFICE VISIT: 99203, 99204, 99205
  • FOLLOW-UP VISITS (x3): 99213, 99214, 99215
  • EEG: 95816, 95819
  • EMG: 95886 (x2)
  • NCV: 95910, 95909, 95908

Please contact our Main Office during normal business hours at: (209) 521-0767 with questions, PRESS 1 for PROVIDER.