CPT code 96121: Neurobehavioral exam, each additional hour2026 Medicare rate & RVUs in New Mexico

Reports additional physician or qualified health care professional time assessing cognitive and behavioral functioning beyond the initial neurobehavioral status examination.

CMS RVU26DEffective Oct 1, 2026One payment locality32.2K Medicare services in 2024

In New Mexico, Medicare pays $74.06 for 96121 in the office and $61.19 when it’s performed in a hospital or facility.

$74.06Office (non-facility)
$61.19Hospital or facility
−1.9%vs the national office rate ($75.49)

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.

We’ll open 96121 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Mexico
  2. What 96121 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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 New Mexico 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. New Mexico pays $74.06. The RVUs are the same everywhere; the geographic indexes change the dollars.

96121 in New Mexico vs other payment areas
  1. New Mexico · this page$74.06
  2. Los Angeles, CA · California$81.02+$6.96
  3. Washington, DC area · District of Columbia$81.82+$7.76
  4. Miami, FL · Florida$76.74+$2.68
  5. Chicago, IL · Illinois$76.41+$2.35
  6. Manhattan, NY · New York$82.26+$8.20
  7. Alaska · Alaska$105.07+$31.01

Other areas in New Mexico first, then benchmark localities. Bars start at $0.

Every other payment area

96121 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$73.09$60.81
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

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
96121 office rate range by state
State / territoryOffice rate rangeLocalities
AK$105.071
AL$73.091
AR$72.781
AZ$74.881
CA$78.03–$89.5929
CO$77.251
CT$78.091
DC$81.821
DE$75.521
FL$74.86–$76.743
GA$73.60–$76.012
GU$77.821
HI$77.821
IA$73.751
ID$73.871
IL$74.10–$76.634
IN$74.001
KS$73.591
KY$73.461
LA$73.40–$74.472
MA$77.29–$81.292
MD$76.25–$81.823
ME$73.92–$75.202
MI$73.96–$75.082
MN$75.771
MO$72.99–$74.623
MS$72.891
MT$75.491
NC$74.161
ND$75.291
NE$73.891
NH$76.181
NJ$79.46–$81.992
NM$74.061
NV$75.451
NY$74.49–$82.845
OH$73.921
OK$73.481
OR$75.31–$78.322
PA$73.99–$77.322
PR$75.681
RI$77.131
SC$74.071
SD$75.261
TN$73.691
TX$73.84–$76.618
UT$74.371
VA$75.08–$81.822
VI$75.681
VT$75.141
WA$77.10–$82.372
WI$74.501
WV$73.271
WY$75.401

See 96121 in every payment locality

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

Office or facility?

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 New Mexico 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

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Office calculation for 96121 in New Mexico
ComponentRVULocality factorAdjusted
Physician work1.71× 1.0001.7100
Practice expense0.54× 0.9170.4952
Malpractice0.01× 1.2010.0120
Total RVUs2.2172
Conversion factor× 33.4009

Office rate, New Mexico$74.06

Office: (1.71 × 1 + 0.54 × 0.917 + 0.01 × 1.201) × $33.4009 = $74.06

Facility: (1.71 × 1 + 0.12 × 0.917 + 0.01 × 1.201) × $33.4009 = $61.19

Open 96121 in the RVU calculator

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

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

How 96121 has changed in New Mexico

96121 · Office / nonfacility

$74.06

Effective 2026-10-01

The base rate is $2.55 higher than on 2025-10-01, moving from $71.51 to $74.06 (3.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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
  1. January 1, 2026

    RVU26A

    $71.51changed to$74.06

    • 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
    • Practice expense GPCI 0.908 changed to 0.917
    • Malpractice GPCI 1.172 changed to 1.201

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $73.59changed to$71.51

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $72.39changed to$73.59

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $74.51changed to$72.39

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.49 changed to 0.50
    • Practice expense GPCI 0.902 changed to 0.908
    • Malpractice GPCI 1.169 changed to 1.172
  5. January 1, 2023

    RVU23A

    $78.53changed to$74.51

    • 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
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 1.166 changed to 1.169

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $80.84changed to$78.53

    • 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.

  7. January 1, 2021

    RVU21A

    $84.97changed to$80.84

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.59 changed to 0.56
    • Practice expense GPCI 0.908 changed to 0.896
    • Malpractice GPCI 1.207 changed to 1.166

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $82.81changed to$84.97

    • 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
    • Practice expense GPCI 0.921 changed to 0.908
    • Malpractice GPCI 1.247 changed to 1.207

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    No ratechanged to$82.81

    Held through RVU19B, RVU19C, RVU19D.

  10. 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.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$74.06$61.19RVU26D
2026-07-01$74.06$61.19RVU26C
2026-04-01$74.06$61.19RVU26B
2026-01-01$74.06$61.19RVU26A
2025-10-01$71.51$63.29RVU25D
2025-07-01$71.51$63.29RVU25C
2025-04-01$71.51$63.29RVU25B
2025-01-01$71.51$63.29RVU25A
2024-10-01$73.59$65.13RVU24D
2024-07-01$73.59$65.13RVU24C
2024-04-01$73.59$65.13RVU24B
2024-03-09$73.59$65.13RVU24AR
2024-01-01$72.39$64.07RVU24A
2023-10-01$74.51$66.56RVU23D
2023-07-01$74.51$66.56RVU23C
2023-04-01$74.51$66.56RVU23B
2023-01-01$74.51$66.56RVU23A
2022-10-01$78.53$71.09RVU22D
2022-07-01$78.53$71.09RVU22C
2022-04-01$78.53$71.09RVU22B
2022-01-01$78.53$71.09RVU22A
2021-10-01$80.84$73.65RVU21D
2021-07-01$80.84$73.65RVU21C
2021-04-01$80.84$73.65RVU21B
2021-01-01$80.84$73.65RVU21A
2020-10-01$84.97$79.40RVU20D
2020-07-01$84.97$79.40RVU20C
2020-04-01$84.97$79.40RVU20B
2020-01-01$84.97$79.40RVU20A
2019-10-01$82.81$79.16RVU19D
2019-07-01$82.81$79.16RVU19C
2019-04-01$82.81$79.16RVU19B
2019-01-01$82.81$79.16RVU19A
2018-10-01Not in this releaseNot in this releaseRVU18D
2018-07-01Not in this releaseNot in this releaseRVU18C
2018-04-01Not in this releaseNot in this releaseRVU18B
2018-01-01Not in this releaseNot in this releaseRVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 96121 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

  • Abeytas
  • Abiquiu
  • Acomita Lake
  • Adelino
  • Agua Fria
  • Alamillo
  • Alamo
  • Alamogordo

Browse all communities in New Mexico

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
RVUs for 96121PPRRVU2026_Oct_nonQPP.csv, line 12,752 (RVU26D)
Geographic factors for New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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