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CPT 96127 Fee Schedule

Last Verified: November 2025

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.

Brief Emotional/Behavioral Assessment (Eg Depression Inventory Attention-Deficit/ Hyperactivity Disorder [Adhd] Scale) With Scoringand Documentation Per Standardized Instrument
Key FactDetail
Service Type

Medicine Services and Procedures

Central Nervous System Assessments/Tests (eg, Neuro-Cognitive, Mental Status, Speech Testing)

Common Place of Service

11 - Office

None

Common Modifiers

None

59 - Distinct Procedural Service

33 - Preventive Services

Complexity LevelLow

National average reimbursement for CPT 96127 by major payers:

bcbs

$5.90

uhc

$6.70

aetna

$6.31

cigna

$14.99

Preview provider-level rates for...
For billing codeCPT 96127
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 96127

United
96127$11.861801886106 - CRAIG BEST43400617 - TUFTS MEDICAL CENTER PARENT INCMAObstetrics & Gynecology Physician (207V00000X)
United
96127$8.181376658682 - TAMMY NOVAK352594698ILObstetrics & Gynecology Physician (207V00000X)
United
96127$3.661255392890 - JOSEPH KING853724514 - (FL) ALL INCLUSIVE PREVENTIVE CARE LLCFLObstetrics & Gynecology Physician (207V00000X)
United
96127$19.791790741353 - KRISTIINA ALTMAN520595110 - JOHNS HOPKINS UNIVERSITYMDObstetrics & Gynecology Physician (207V00000X)
United
96127$5.461184990178 - JASON MCMASTER383603423 - (MI) MERCY WOMENS HEALTH SERVICESFLObstetrics & Gynecology Physician (207V00000X)
United
96127$5.031720297013 - HOWARD BENNETT821381539 - TULLAHOMA WOMENS HEALTHTNObstetrics & Gynecology Physician (207V00000X)
United
96127$8.461952667487 - JEANNETTE LOPIANO590714812 - LEE MEMORIAL HEALTH SYSTEMFLObstetrics & Gynecology Physician (207V00000X)
United
96127$8.771720342900 - MEENA DEMETRIOS592292041 - (FL) ST VINCENTS AMBULATORY CARE INCFLObstetrics & Gynecology Physician (207V00000X)
United
96127$12.251487686176 - ASTRID JAIN850629801NCObstetrics & Gynecology Physician (207V00000X)
United
96127$11.891427131200 - MALIERI COLON-RIVERA811291017 - (FL) WOMENS HEALTH HOSPITALISTS LLCFLObstetrics & Gynecology Physician (207V00000X)
United
96127$8.561417383498 - ALLEGHENY CLINIC, JEFFERSON WOMEN'S HEALTH251838458 - HIGHMARK HEALTHPAObstetrics & Gynecology Physician (207V00000X)
United
96127$8.891194952333 - MARY JOHNSTON590634434 - SACRED HEART HEALTH SYSTEM INCFLObstetrics & Gynecology Physician (207V00000X)
United
96127$10.921487662060 - MARY ANDERSON383852646 - OSF MULTI-SPECIALTY GROUPWIObstetrics & Gynecology Physician (207V00000X)
United
96127$11.891104812296 - JOHN MARSTON593443182 - WOMENS CARE FLORIDA, LLPFLObstetrics & Gynecology Physician (207V00000X)
United
96127$4.091871598847 - PEDRO SEGARRA132828349 - SUN RIVER HEALTH INCNYObstetrics & Gynecology Physician (207V00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 96127 vs. Other Central Nervous System Assessments/Tests (eg, Neuro-Cognitive, Mental Status, Speech Testing) Codes

The CPT 96127 code is part of the Medicine Services and Procedures services used for Central Nervous System Assessments/Tests (eg, Neuro-Cognitive, Mental Status, Speech Testing). 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 96127 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.

CodeComplexityDescription
96125-CPTLowStandardized Cognitive Performance Testing (Eg Ross Information Processing Assessment) Per Hour Of A Qualified Health Care Professionalstime Both Face To Face Time Administering Tests To The Patient And Time Interpreting These Test Results And Preparing The Report
96127-CPTLowBrief Emotional/Behavioral Assessment (Eg Depression Inventory Attention-Deficit/ Hyperactivity Disorder [Adhd] Scale) With Scoringand Documentation Per Standardized Instrument
96130-CPTLowPsychological Testing Evaluation Services By Phy- Sician Or Other Qualified Health Care Professionalincluding Integration Of Patient Data Interpre- Tation Of Standardized Test Results And Clinical Decision Making Treatment Planning And Report And Interactive Feedback To The Patient Family Member(S) Or Caregiver(S) When Performed; First Hour
96131-CPTLowPsychological Testing Evaluation Services By Phy- Sician Or Other Qualified Health Care Professionalincluding Integration Of Patient Data Interpre- Tation Of Standardized Test Results And Clinical Decision Making Treatment Planning And Report And Interactive Feedback To The Patient Family Member(S) Or Caregiver(S) When Performed; Each Additional Hour (List Separately In Addition To Code For Primary Procedure)

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 96127. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 96127 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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