CPT code 96121: Neurobehavioral exam, each additional hour2026 Medicare rate & RVUs in Washington, DC area
Reports additional physician or qualified health care professional time assessing cognitive and behavioral functioning beyond the initial neurobehavioral status examination.
In Washington, DC area, Medicare pays $81.82 for 96121 in the office and $65.29 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 96121 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 96121 covers
This add-on reports additional professional time spent evaluating cognitive and behavioral functioning, such as attention, memory, language, reasoning, judgment, planning, and problem solving. A physician or other qualified health care professional may perform the assessment in an office, hospital, or other appropriate setting when a patient has concerns such as cognitive changes after a brain injury, stroke, or suspected dementia. The service can include clinical assessment, review and interpretation of relevant findings, and preparation of the report.
Report 96121 only with 96116, the initial-hour neurobehavioral status examination. Documentation should identify the clinical concern, assessment performed, findings, and the time supporting the additional hour. This is an add-on code: CMS pays it only when reported with its primary procedure, and its payment falls within that procedure’s global period. Do not report it as a stand-alone service.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How Washington, DC area compares for 96121
Across 109 of 109 payment localities, the office rate for 96121 runs from $72.78 in Arkansas to $105.07 in Alaska. Washington, DC area pays $81.82. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Washington, DC area · this page$81.82
- Los Angeles, CA · California$81.02−$0.80
- Miami, FL · Florida$76.74−$5.08
- Chicago, IL · Illinois$76.41−$5.41
- Manhattan, NY · New York$82.26+$0.44
- Alaska · Alaska$105.07+$23.25
- Alabama · Alabama$73.09−$8.73
Other areas in District of Columbia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | $72.78 | $60.73 |
| ArizonaArizona | $74.88 | $61.29 |
| Bakersfield, CACalifornia | $78.17 | $62.80 |
| Chico, CACalifornia | $78.03 | $62.66 |
| El Centro, CACalifornia | $78.04 | $62.66 |
| Fresno, CACalifornia | $78.03 | $62.66 |
| Hanford, CACalifornia | $78.03 | $62.66 |
| Madera, CACalifornia | $78.03 | $62.66 |
| Merced, CACalifornia | $78.03 | $62.66 |
| Modesto, CACalifornia | $78.03 | $62.66 |
| Napa, CACalifornia | $84.66 | $66.17 |
| Oxnard, CACalifornia | $80.24 | $63.66 |
| Redding, CACalifornia | $78.03 | $62.66 |
| Rest of CaliforniaCalifornia | $78.03 | $62.66 |
| Riverside, CACalifornia | $78.20 | $62.82 |
| Sacramento, CACalifornia | $80.33 | $64.01 |
| Salinas, CACalifornia | $79.97 | $63.71 |
| San Diego, CACalifornia | $80.58 | $63.80 |
| Marin County, CACalifornia | $88.13 | $68.35 |
| San Francisco, CACalifornia | $88.11 | $68.33 |
| San Benito County, CACalifornia | $89.59 | $69.36 |
| Santa Clara County, CACalifornia | $89.54 | $69.31 |
| San Luis Obispo, CACalifornia | $78.81 | $62.83 |
| Santa Cruz, CACalifornia | $80.41 | $63.36 |
| Santa Maria, CACalifornia | $79.92 | $63.57 |
| Santa Rosa, CACalifornia | $81.16 | $63.93 |
| Stockton, CACalifornia | $78.03 | $62.66 |
| Vallejo, CACalifornia | $84.64 | $66.15 |
| Visalia, CACalifornia | $78.03 | $62.66 |
| Yuba City, CACalifornia | $78.03 | $62.66 |
| ColoradoColorado | $77.25 | $62.33 |
| ConnecticutConnecticut | $78.09 | $62.98 |
| DelawareDelaware | $75.52 | $61.66 |
| Fort Lauderdale, FLFlorida | $75.99 | $61.78 |
| Rest of FloridaFlorida | $74.86 | $61.45 |
| Atlanta, GAGeorgia | $76.01 | $61.76 |
| Rest of GeorgiaGeorgia | $73.60 | $61.09 |
| Hawaii, Guam, HIHawaii | $77.82 | $61.87 |
| IowaIowa | $73.75 | $60.92 |
| IdahoIdaho | $73.87 | $60.96 |
| East St. Louis, ILIllinois | $74.38 | $61.48 |
| Rest of IllinoisIllinois | $74.10 | $61.30 |
| Suburban Chicago, ILIllinois | $76.63 | $62.22 |
| IndianaIndiana | $74.00 | $60.99 |
| KansasKansas | $73.59 | $60.91 |
| KentuckyKentucky | $73.46 | $60.98 |
| New Orleans, LALouisiana | $74.47 | $61.27 |
| Rest of LouisianaLouisiana | $73.40 | $60.98 |
| Metropolitan Boston, MAMassachusetts | $81.29 | $64.54 |
| Rest of MassachusettsMassachusetts | $77.29 | $62.52 |
| Baltimore area, MDMaryland | $77.80 | $62.74 |
| Rest of MarylandMaryland | $76.25 | $62.05 |
| Rest of MaineMaine | $73.92 | $61.01 |
| Southern Maine, MEMaine | $75.20 | $61.30 |
| Detroit, MIMichigan | $75.08 | $61.55 |
| Rest of MichiganMichigan | $73.96 | $61.15 |
| MinnesotaMinnesota | $75.77 | $61.34 |
| Metropolitan Kansas City, MOMissouri | $74.38 | $61.21 |
| Metropolitan St. Louis, MOMissouri | $74.62 | $61.27 |
| Rest of MissouriMissouri | $72.99 | $60.90 |
| MississippiMississippi | $72.89 | $60.81 |
| MontanaMontana | $75.49 | $61.46 |
| North CarolinaNorth Carolina | $74.16 | $61.07 |
| North DakotaNorth Dakota | $75.29 | $61.26 |
| NebraskaNebraska | $73.89 | $60.94 |
| New HampshireNew Hampshire | $76.18 | $61.58 |
| Northern New JerseyNew Jersey | $81.99 | $65.72 |
| Rest of New JerseyNew Jersey | $79.46 | $64.14 |
| New MexicoNew Mexico | $74.06 | $61.19 |
| NevadaNevada | $75.45 | $61.41 |
| NYC suburbs and Long Island, NYNew York | $82.84 | $66.16 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $79.84 | $64.48 |
| Queens, NYNew York | $82.57 | $65.99 |
| Rest of New YorkNew York | $74.49 | $61.16 |
| OhioOhio | $73.92 | $61.11 |
| OklahomaOklahoma | $73.48 | $60.95 |
| Portland, OROregon | $78.32 | $62.73 |
| Rest of OregonOregon | $75.31 | $61.34 |
| Metropolitan Philadelphia, PAPennsylvania | $77.32 | $62.71 |
| Rest of PennsylvaniaPennsylvania | $73.99 | $61.11 |
| Puerto RicoPuerto Rico | $75.68 | $61.50 |
| Rhode IslandRhode Island | $77.13 | $62.64 |
| South CarolinaSouth Carolina | $74.07 | $61.10 |
| South DakotaSouth Dakota | $75.26 | $61.24 |
| TennesseeTennessee | $73.69 | $60.94 |
| Austin, TXTexas | $76.61 | $61.77 |
| Beaumont, TXTexas | $73.84 | $61.07 |
| Brazoria, TXTexas | $75.71 | $61.81 |
| Dallas, TXTexas | $75.88 | $61.91 |
| Fort Worth, TXTexas | $75.70 | $61.87 |
| Galveston, TXTexas | $75.76 | $61.83 |
| Houston, TXTexas | $75.94 | $62.01 |
| Rest of TexasTexas | $74.53 | $61.22 |
| UtahUtah | $74.37 | $61.18 |
| VirginiaVirginia | $75.08 | $61.29 |
| Virgin Islands, VIUnited States Virgin Islands | $75.68 | $61.50 |
| VermontVermont | $75.14 | $61.25 |
| Rest of WashingtonWashington | $77.10 | $62.33 |
| King County, WAWashington | $82.37 | $65.16 |
| WisconsinWisconsin | $74.50 | $61.06 |
| West VirginiaWest Virginia | $73.27 | $61.08 |
| WyomingWyoming | $75.40 | $61.37 |
96121 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$72.78
$105.07
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $105.07 | 1 |
| AL | $73.09 | 1 |
| AR | $72.78 | 1 |
| AZ | $74.88 | 1 |
| CA | $78.03–$89.59 | 29 |
| CO | $77.25 | 1 |
| CT | $78.09 | 1 |
| DC | $81.82 | 1 |
| DE | $75.52 | 1 |
| FL | $74.86–$76.74 | 3 |
| GA | $73.60–$76.01 | 2 |
| GU | $77.82 | 1 |
| HI | $77.82 | 1 |
| IA | $73.75 | 1 |
| ID | $73.87 | 1 |
| IL | $74.10–$76.63 | 4 |
| IN | $74.00 | 1 |
| KS | $73.59 | 1 |
| KY | $73.46 | 1 |
| LA | $73.40–$74.47 | 2 |
| MA | $77.29–$81.29 | 2 |
| MD | $76.25–$81.82 | 3 |
| ME | $73.92–$75.20 | 2 |
| MI | $73.96–$75.08 | 2 |
| MN | $75.77 | 1 |
| MO | $72.99–$74.62 | 3 |
| MS | $72.89 | 1 |
| MT | $75.49 | 1 |
| NC | $74.16 | 1 |
| ND | $75.29 | 1 |
| NE | $73.89 | 1 |
| NH | $76.18 | 1 |
| NJ | $79.46–$81.99 | 2 |
| NM | $74.06 | 1 |
| NV | $75.45 | 1 |
| NY | $74.49–$82.84 | 5 |
| OH | $73.92 | 1 |
| OK | $73.48 | 1 |
| OR | $75.31–$78.32 | 2 |
| PA | $73.99–$77.32 | 2 |
| PR | $75.68 | 1 |
| RI | $77.13 | 1 |
| SC | $74.07 | 1 |
| SD | $75.26 | 1 |
| TN | $73.69 | 1 |
| TX | $73.84–$76.61 | 8 |
| UT | $74.37 | 1 |
| VA | $75.08–$81.82 | 2 |
| VI | $75.68 | 1 |
| VT | $75.14 | 1 |
| WA | $77.10–$82.37 | 2 |
| WI | $74.50 | 1 |
| WV | $73.27 | 1 |
| WY | $75.40 | 1 |
How the 96121 rate is calculated
Each of 96121’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 96121
RVUs × geographic indexes × conversion factor
Work1.71
1.71 RVUs× 1.000 GPCI
Practice expense0.54
0.54 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
2.2600
Conversion factor
$33.4009
Medicare rate
$75.49
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Washington, DC area inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,752
- Code
- 96121
- Physician work
- 1.71
- Practice expense
- 0.54
- Malpractice
- 0.01
GPCI2026.csv
39
- Locality
- Washington, DC area
- Physician work
- 1.054
- Practice expense
- 1.178
- Malpractice
- 1.113
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.71 | × 1.054 | 1.8023 |
| Practice expense | 0.54 | × 1.178 | 0.6361 |
| Malpractice | 0.01 | × 1.113 | 0.0111 |
| Total RVUs | 2.4496 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Washington, DC area$81.82
Office: (1.71 × 1.054 + 0.54 × 1.178 + 0.01 × 1.113) × $33.4009 = $81.82
Facility: (1.71 × 1.054 + 0.12 × 1.178 + 0.01 × 1.113) × $33.4009 = $65.29
Payment rules and modifiers for 96121
The CMS indicators that decide how 96121 is paid alongside other services.
CMS payment indicators · 96121
Neurobehavioral exam, each additional hour
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
How 96121 has changed in Washington, DC area
96121 · Office / nonfacility
$81.82
Effective 2026-10-01
The base rate is $2.56 higher than on 2025-10-01, moving from $79.26 to $81.82 (3.2%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$79.26changed to$81.82
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.50 changed to 0.54
- Malpractice RVU 0.04 changed to 0.01
- Work GPCI 1.057 changed to 1.054
- Practice expense GPCI 1.192 changed to 1.178
- Malpractice GPCI 1.168 changed to 1.113
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$81.56changed to$79.26
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$80.23changed to$81.56
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$83.02changed to$80.23
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.49 changed to 0.50
- Work GPCI 1.056 changed to 1.057
- Practice expense GPCI 1.214 changed to 1.192
- Malpractice GPCI 1.231 changed to 1.168
January 1, 2023
RVU23A
$88.20changed to$83.02
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.52 changed to 0.49
- Malpractice RVU 0.08 changed to 0.04
- Work GPCI 1.054 changed to 1.056
- Practice expense GPCI 1.236 changed to 1.214
- Malpractice GPCI 1.294 changed to 1.231
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$91.10changed to$88.20
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.56 changed to 0.52
- Malpractice RVU 0.09 changed to 0.08
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$94.88changed to$91.10
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.59 changed to 0.56
- Work GPCI 1.049 changed to 1.054
- Practice expense GPCI 1.221 changed to 1.236
- Malpractice GPCI 1.277 changed to 1.294
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$91.05changed to$94.88
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.53 changed to 0.59
- Malpractice RVU 0.08 changed to 0.09
- Work GPCI 1.045 changed to 1.049
- Practice expense GPCI 1.205 changed to 1.221
- Malpractice GPCI 1.261 changed to 1.277
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
No ratechanged to$91.05
Held through RVU19B, RVU19C, RVU19D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $81.82 | $65.29 | RVU26D |
| 2026-07-01 | $81.82 | $65.29 | RVU26C |
| 2026-04-01 | $81.82 | $65.29 | RVU26B |
| 2026-01-01 | $81.82 | $65.29 | RVU26A |
| 2025-10-01 | $79.26 | $68.46 | RVU25D |
| 2025-07-01 | $79.26 | $68.46 | RVU25C |
| 2025-04-01 | $79.26 | $68.46 | RVU25B |
| 2025-01-01 | $79.26 | $68.46 | RVU25A |
| 2024-10-01 | $81.56 | $70.45 | RVU24D |
| 2024-07-01 | $81.56 | $70.45 | RVU24C |
| 2024-04-01 | $81.56 | $70.45 | RVU24B |
| 2024-03-09 | $81.56 | $70.45 | RVU24AR |
| 2024-01-01 | $80.23 | $69.30 | RVU24A |
| 2023-10-01 | $83.02 | $72.32 | RVU23D |
| 2023-07-01 | $83.02 | $72.32 | RVU23C |
| 2023-04-01 | $83.02 | $72.32 | RVU23B |
| 2023-01-01 | $83.02 | $72.32 | RVU23A |
| 2022-10-01 | $88.20 | $77.93 | RVU22D |
| 2022-07-01 | $88.20 | $77.93 | RVU22C |
| 2022-04-01 | $88.20 | $77.93 | RVU22B |
| 2022-01-01 | $88.20 | $77.93 | RVU22A |
| 2021-10-01 | $91.10 | $81.19 | RVU21D |
| 2021-07-01 | $91.10 | $81.19 | RVU21C |
| 2021-04-01 | $91.10 | $81.19 | RVU21B |
| 2021-01-01 | $91.10 | $81.19 | RVU21A |
| 2020-10-01 | $94.88 | $87.39 | RVU20D |
| 2020-07-01 | $94.88 | $87.39 | RVU20C |
| 2020-04-01 | $94.88 | $87.39 | RVU20B |
| 2020-01-01 | $94.88 | $87.39 | RVU20A |
| 2019-10-01 | $91.05 | $86.28 | RVU19D |
| 2019-07-01 | $91.05 | $86.28 | RVU19C |
| 2019-04-01 | $91.05 | $86.28 | RVU19B |
| 2019-01-01 | $91.05 | $86.28 | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Washington, DC area rate applies
Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.
- Washington
96121 billing questions
What must be reported with 96121?
Report 96121 with 96116, which covers the initial hour of the neurobehavioral status examination. CMS treats 96121 as an add-on and pays it within the primary procedure’s global period.
How is 96121 different from 96116?
96116 reports the initial-hour service; 96121 reports additional time for that same neurobehavioral assessment. Do not use 96121 by itself.
How is this different from neuropsychological testing evaluation?
96121 extends a clinical neurobehavioral status examination. Codes 96132 and 96133 are for neuropsychological testing evaluation, a distinct service; select based on the work actually performed and documented.
What documentation supports an additional unit?
Document the assessment activities, relevant findings, and time attributable to the additional service. The record should make clear that the work extends the 96116 examination rather than describing a separate service.
Can 96121 be billed for testing administration?
96121 reports additional neurobehavioral assessment time, not test administration and scoring by themselves. For psychological or neuropsychological test administration and scoring, consider the applicable testing codes when that work was performed.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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