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See a sample rate comparisonCPT 96137 Fee Schedule
Last Verified: October 2026
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.
Psycl Nrpsyc Tst Phy Qhp Ea, Psychological Or Neuropsychological Test Administration And Scoring By Physician Or Other Qualified Health Care Professional Two Or More Tests Any Method Each Additional 30 Minutes List Separately In Addition To Code For Primary Procedure
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Central Nervous System Assessments/Tests (eg, Neuro-Cognitive, Mental Status, Speech Testing) |
| Common Place of Service | 11 - Office |
| Common Modifiers | AH 95 - Telemedicine - audio and video |
| Complexity Level | Low |
| Medicare Fee Schedule | $37.08 national non-facility rate (2026) · View Medicare rates for 96137 |
| Medicaid Fee Schedule | $32.76 median of the 8 states in the free preview · View Medicaid rates for 96137 |
National average reimbursement for CPT 96137 by major payers:
$47.98
$51.21
$48.26
$63.66
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CPT 96137
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$109.52Published ratePatricia Wilson
Ear Nose And Throat Consultants PC
$46.68Published rateRebecca Davis Holland
$39.33Published rateGonchigari Narayana
$39.31Published rateAmy French
$26.96Published rate
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See a sample payer proposalCPT 96137 vs. Other Central Nervous System Assessments/Tests (eg, Neuro-Cognitive, Mental Status, Speech Testing) Codes
The CPT 96137 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 96137 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 |
|---|---|---|
| 96136-CPT | Low | Psycl Nrpsyc Tst Phy Qhp 1st, Psychological Or Neuropsychological Test Administration And Scoring By Physician Or Other Qualified Health Care Professional Two Or More Tests Any Method First 30 Minutes |
| 96137-CPT | Low | Psycl Nrpsyc Tst Phy Qhp Ea, Psychological Or Neuropsychological Test Administration And Scoring By Physician Or Other Qualified Health Care Professional Two Or More Tests Any Method Each Additional 30 Minutes List Separately In Addition To Code For Primary Procedure |
| 96138-CPT | Low | Psychological Test 30 Mins, Psychological Test With Physician Interpretation And Report. Standardized Tests Can Be Used To Assess Multiple Facets Of Personality Emotion Intellect And Mental Illness. |
| 96139-CPT | Low | Psychological Or Neuropsycholo, Psychological Or Neuropsychological Test Administration And Scoring By Technician Two Or More Tests Any Method Each Additional 30 Minutes (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 96137. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 96137 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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