CPT 96002 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Medicine Services and Procedures • Neurology and Neuromuscular Procedures |
| Common Place of Service | • 11 - Office • 19 - Off Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
National average reimbursement for CPT 96002 by major payers:
$28.62
$27.94
$28.47
$36.70
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 96002 | ||||||
United | 96002 | $40.25 | 1275767386 - ERIN ZAHRADNIK | 362177139 - UNIVERSITY OF CHICAGO | IL | Psychiatry Physician (2084P0800X) |
United | 96002 | $37.41 | 1780830794 - KARA DRISCOLL | 232919472 - UPMC | IL | Psychiatry Physician (2084P0800X) |
United | 96002 | $48.18 | 1144203753 - HAIDAR KABBANI | 383852646 - OSF MULTI-SPECIALTY GROUP | OH | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 96002 | $28.93 | 1891180170 - SURYA SABHAPATHY | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Psychiatry Physician (2084P0800X) |
United | 96002 | $27.02 | 1437438249 - KAPIL AEDMA | 430957840 - SWOPE HEALTH SERVICES | MO | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 96002 | $22.89 | 1477997674 - OLGA KOZLOVA | 471293653 - GANESHA INSTITUTE OF NEUROLOGY AND PSYCHIATRY, S.C. | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 96002 | $18.27 | 1922111657 - CLINT ANTHONY | 208106540 - DISTRICT MEDICAL GROUP INC | IL | Psychiatry Physician (2084P0800X) |
United | 96002 | $28.93 | 1720547672 - PERRY TSAI | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Psychiatry Physician (2084P0800X) |
United | 96002 | $37.77 | 1942650130 - MALIK NASSAN | 362679194 - (IL) HEAD & NECK AND COSMETIC SURGERY ASSOCIATES, LLC | IL | Psychiatry Physician (2084P0800X) |
United | 96002 | $36.11 | 1306340880 - GEORGE GIANAKAKOS | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | FL | Psychiatry Physician (2084P0800X) |
United | 96002 | $34.36 | 1699752204 - CATHERINE CAMILLERI | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Psychiatry Physician (2084P0800X) |
United | 96002 | $26.14 | 1578555256 - VIKTORIA ERHARDT | 363317058 - (IL) ACCESS COMMUNITY HEALTH NETWORK | IL | Psychiatry Physician (2084P0800X) |
United | 96002 | $46.97 | 1497080584 - ELIZABETH HOMAN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | MN | Psychiatry Physician (2084P0800X) |
United | 96002 | $46.63 | 1003010059 - ANDREA PARDO | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 96002 | $43.20 | 1891921367 - KAVITA THAKKAR | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | PA | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 96002 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 96002 code is part of the Medicine Services and Procedures services used for Neurology and Neuromuscular Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 96002 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 95992-CPT | Low | Canalith Repositioning Procedure(S) (Eg, Epley Maneuver, Semont Maneuver), Per Day |
| 96000-CPT | Low | Comprehensive Computer-Based Motion Analysis By Video-Taping And 3-D Kinematics |
| 96001-CPT | Low | Comprehensive Computer-Based Motion Analysis By Video-Taping And 3-D Kinematics; With Dynamic Plantar Pressure Measurements During Walking |
| 96002-CPT | Low | Dynamic Surface Electromyography, During Walking Or Other Functional Activities, 1-12 Muscles |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 96002. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 96002 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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