CPT 96020 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Moderate |
National average reimbursement for CPT 96020 by major payers:
$214.80
$332.69
$274.10
$522.84
| 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 96020 | ||||||
United | 96020 | $444.45 | 1689010373 - EWA BIEBER | 364187449 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 96020 | $224.53 | 1104230036 - AFSANEH TALAI | 756002868 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 96020 | $301.11 | 1922452408 - SONYA MOHAN | 911780160 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 96020 | $317.89 | 1972501252 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 96020 | $260.70 | 1689787426 - KAREN SEVERSON | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | MT | Psychiatry Physician (2084P0800X) |
United | 96020 | $272.66 | 1356352447 - MARLA HARTZEN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 96020 | $419.47 | 1275911067 - ELIZABETH HARARI | 911780160 | IL | Psychiatry Physician (2084P0800X) |
United | 96020 | $208.88 | 1376040014 - JODY WONG | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Psychiatry Physician (2084P0800X) |
United | 96020 | $93.56 | 1578957676 - LAURA VERNON | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | NY | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 96020 | $323.64 | 1730263617 - MARK ALTER | 910844563 | PA | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 96020 | $250.27 | 1437492493 - ASHLEY MULVIHILL | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 96020 | $339.17 | 1518124932 - RITU TALWAR | 363994258 - (IL) HORIZONS BEHAVIORAL HEALTH LLC | IL | Psychiatry Physician (2084P0800X) |
United | 96020 | $309.02 | 1548279870 - VINOD ALLURI | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 96020 | $451.92 | 1386755486 - DOUGLAS NORDLI | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 96020 | $245.55 | 1487841540 - CEZARY DUDZINSKI | 363149833 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Psychiatry Physician (2084P0800X) |
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 96020 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 96020 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 96020 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 |
|---|---|---|
| 95983-CPT | Low | Electronic Analysis Of Implanted Neurostimulator Pulse Generator/Transmitter (Eg, Contact Group[S], Interleaving, Amplitude, Pulse Width, Frequency [Hz], On/Off Cycling, Burst, Magnet Mode, Dose Lockout, Patient Selectable Parameters, Responsive Neurostimulation, Detection Algorithms, Closed Loop Parameters, And Passive Parameters) By Physician Or Other Qualified Health Care Professional; With Brain Neurostimulator Pulse Generator/Transmitter Programming, First 15 Minutes Face-To-Face Time With |
| 95984-CPT | Low | Electronic Analysis Of Implanted Neurostimulator Pulse Generator/Transmitter (Eg, Contact Group[S], Interleaving, Amplitude, Pulse Width, Frequency [Hz], On/Off Cycling, Burst, Magnet Mode, Dose Lockout, Patient Selectable Parameters, Responsive Neurostimulation, Detection Algorithms, Closed Loop Parameters, And Passive Parameters) By Physician Or Other Qualified Health Care Professional; With Brain Neurostimulator Pulse Generator/Transmitter Programming, Each Additional 15 Minutes Face-To-Face |
| 96000-CPT | Low | Comprehensive Computer-Based Motion Analysis By Video-Taping And 3-D Kinematics |
| 96020-CPT | Moderate | Neurofunctional Testing Selection And Administration During Noninvasive Imaging Functional Brain Mapping With Test Administered Entirely By A Physician Or Other Qualified Health Care Professional (Ie Psychologist) With Review Of Test Results And Report (Revised 01/01/13) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 96020. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 96020 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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