Neurofeedback therapy—an emerging technique that uses real-time brainwave monitoring to treat mental health conditions—sits at the crossroads of neuroscience and behavioral medicine. Like any reimbursable medical service, it’s subject to strict billing rules. But as a relatively new therapy, it presents challenges in identifying the correct billing codes.
Neurofeedback resembles biofeedback, a more established modality. Biofeedback tracks physiological metrics such as respiration, heart rate, and muscle tension. Neurofeedback, by contrast, monitors brain activity. While biofeedback has an established CPT code (90901), neurofeedback appears to lack a distinct code—leaving providers to navigate a gray area.
A recent federal indictment—United States v. Luthor & Brown, No. 0:25-cr-00088-PAM-ECW (D. Minn.)—highlights the hazards of operating in that gray area. For providers, counsel, and compliance officers, the case serves as a cautionary tale about billing for novel therapies.
The Legal Case: Alleged Scheme of Misrepresentation
Filed in March 2025, the indictment charges Gabriel Adam Alexander Luthor and Elizabeth Christine Brown, co-founders of Golden Victory Medical LLC (GVM), with orchestrating a years-long scheme to defraud Medicare, Medicaid, and private insurers. From 2018 to 2022, the pair allegedly submitted hundreds of thousands of false claims.
The government outlines three core tactics:
- Misrepresenting services: Billing for care not provided or not medically necessary;
- Manipulating codes: Using inapplicable CPT codes to boost reimbursements, in disregard of guidance;
- Ignoring compliance warnings: Persisting in improper billing despite insurer denials, a CMS payment suspension, and an adverse audit.
Neurofeedback’s Role in the Indictment
The indictment identifies neurofeedback as one of GVM’s principal services. Importantly, the government does not challenge the legitimacy of neurofeedback itself, but rather how it was billed. Specifically, GVM allegedly used CPT 90901—intended for “biofeedback training by any modality”—to bill for neurofeedback.
According to the government, 90901 is generally used for physical conditions such as hypertension or urinary incontinence. Yet GVM used it to bill for neurofeedback treating psychological symptoms. This alleged mismatch is central to the fraud theory: the use of a broader, better-reimbursed code for a service that lacks explicit coverage.
Because there does not appear to be a specific CPT code for neurofeedback, this raises a vexing question: What is the correct code?
A Billing Experiment: Asking ChatGPT
Out of curiosity, we posed this prompt to ChatGPT (model 4.5):
“Act as an experienced medical billing expert and identify the correct CPT code for neurofeedback procedures.”
ChatGPT’s response:
“As an experienced medical billing expert, the correct CPT code for neurofeedback (also known as EEG biofeedback) procedures is 90901.
Explanation:
- CPT 90901 is designated for ‘Biofeedback training by any modality.’ Under AMA guidelines, EEG biofeedback (i.e., neurofeedback) falls within this category.
- Neurofeedback lacks its own CPT code and is typically billed under 90901.
- Documentation must clearly state that neurofeedback was provided, especially when used for psychological or neurological symptoms.
- Misuse of codes meant for diagnostic EEGs (e.g., 95816, 95819) or psychological testing is a common error.
- Payers vary in their interpretation—some deny 90901 for psychological applications. Always check payer policies.”
While we’re not proposing that healthcare providers treat ChatGPT as a billing authority, the answer illustrates the ambiguity surrounding neurofeedback coding—and underscores the broader concern. If even a well-trained, ‘reasoning’ large language model, reflecting mainstream coding resources, lands on 90901, the case against GVM begins to raise policy, not just criminal, questions.
A Final Note
To be clear, the indictment alleges various fraudulent acts—many of which, if proven, would plainly amount to criminal conduct. But by spotlighting this aspect of the case, we mean to highlight the regulatory uncertainty facing providers of innovative therapies. When enforcement rests on murky coding distinctions, the prudent course when it comes to billing for those services is to proceed with caution, employ rigorous documentation, and seek counsel from legal and regulatory experts.
