CPT 96146 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 • Central Nervous System Assessments/Tests (eg, Neuro-Cognitive, Mental Status, Speech Testing) |
| Common Place of Service | • 11 - Office • None • 10 - Telehealth in Patient's Home |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 95 - Telemedicine - audio and video |
| Complexity Level | Low |
National average reimbursement for CPT 96146 by major payers:
$3.69
$2.79
$2.82
$10.28
| 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 96146 | ||||||
United | 96146 | $2.01 | 1063972404 - MAANASA BANDLA | 370661183 - BLESSING HOSPITAL | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 96146 | $3.93 | 1952815656 - BRIGHTLAND HEALTH LLC, BRIGHTLAND HEALTH | 474008034 - (IL) BRIGHTLAND HEALTH LLC | IL | Psychiatry Physician (2084P0800X) |
United | 96146 | $2.36 | 1881634228 - MARTIN REPETTO | 376001351 - (IL) MACOUPIN COUNTY PUBLIC HEALTH DEPARTMENT | FL | Psychiatry Physician (2084P0800X) |
United | 96146 | $2.41 | 1962664789 - JAMIE EVANS | 811324691 | CA | Psychiatry Physician (2084P0800X) |
United | 96146 | $2.36 | 1730263617 - MARK ALTER | 331075317 - NCHMD INC | WI | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 96146 | $2.38 | 1609883347 - BRAD BERGER | 832734123 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 96146 | $4.17 | 1467802108 - MIRIAM BALTUANO SONGHURST | 863284696 - OU HEALTH PARTNERS INC | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 96146 | $2.36 | 1952521791 - PHILIP WOERNER | 237244801 - (IL) CASS COUNTY MENTAL HEALTH ASSOCIATION | IL | Psychiatry Physician (2084P0800X) |
United | 96146 | $4.71 | 1962791343 - JEREMY WONG | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 96146 | $2.25 | 1760412621 - RHONDA LAMPEN | 911352172 - MULTICARE HEALTH SYSTEM | MI | Psychiatry Physician (2084P0800X) |
United | 96146 | $3.06 | 1114472867 - MARCUS BYRD | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 96146 | $2.49 | 1710470257 - ALAN AKIRA | 871959655 - (IL) CHICAGO BH HOSPITAL LLC | IL | Psychiatry Physician (2084P0800X) |
United | 96146 | $2.73 | 1609883347 - BRAD BERGER | 832734123 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 96146 | $2.49 | 1629162359 - WAJID KHAN | 301009724 | IL | Psychiatry Physician (2084P0800X) |
United | 96146 | $2.67 | 1922111657 - CLINT ANTHONY | 860830701 | AZ | 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 96146 vs. Other Central Nervous System Assessments/Tests (eg, Neuro-Cognitive, Mental Status, Speech Testing) Codes
The CPT 96146 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 96146 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 |
|---|---|---|
| 96105-CPT | Low | Assessment Of Aphasia (Includes Assessment Of Expressive And Receptive Speech And Language Function, Language Comprehension, Speech Production Ability, Reading, Spelling, Writing, Eg, By Boston Diagnostic Aphasia Examination) With Interpretation And Report, Per Hou |
| 96136-CPT | Low | Psychological Or Neuropsychological Test Administration & Scoring By Physician/Other Qhcp, 2 Or More Tests, Any Method; First 30 Minutes Synchronous Telemed Svc Rendered Real Time Audio |
| 96137-CPT | Low | Psychological Or Neuropsychological Test Admini- Stration And Scoring By Physician Or Other Quali- Fied Health Care Professional Two Or More Tests Any Method; Each Additional 30 Minutes (List Separately In Addition To Code For Primary Procedure) |
| 96146-CPT | Low | Psychological Or Neuropsychological Test Administration, With Single Automated, Standardized Instrument Via Electronic Platform, With Automated Result Only |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 96146. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 96146 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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