CPT code 96125: Cognitive testing, per qualified professional hour2026 Medicare rate & RVUs in Atlanta, GA
Report standardized cognitive performance testing when a qualified health professional administers tests, interprets results, and prepares a clinical report.
In Atlanta, GA, Medicare pays $104.03 for 96125 in the office.
Check a contract rate as a % of Medicare · 96125 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 96125 covers
This service covers standardized testing of cognitive performance, such as attention, memory, problem solving, or executive function. A speech-language pathologist may use it to assess cognitive-communication deficits after a stroke or traumatic brain injury; other qualified health professionals may assess cognitive concerns in rehabilitation or similar clinical settings. The work includes administering tests to the patient, interpreting the results, and preparing a report.
Report the code by the qualified professional’s total time for those testing activities, supported by documentation of the clinical reason, tests administered, findings, interpretation, and report. It is a therapy service, so a professional-component modifier does not apply. Under the CMS therapy multiple procedure payment reduction, the practice expense portion is reduced when this is the second or a later therapy unit on the same day.
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 Atlanta, GA compares for 96125
Across 109 of 109 payment localities, the office rate for 96125 runs from $95.92 in Arkansas to $133.57 in Alaska. Atlanta, GA pays $104.03. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Atlanta, GA · this page$104.03
- Rest of Georgia · Georgia$98.30−$5.73
- Los Angeles, CA · California$112.94+$8.91
- Washington, DC area · District of Columbia$114.06+$10.03
- Miami, FL · Florida$106.75+$2.72
- Chicago, IL · Illinois$105.23+$1.20
- Manhattan, NY · New York$114.54+$10.51
Other areas in Georgia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlaskaAlaska | $133.57 | — |
| AlabamaAlabama | $96.70 | — |
| ArkansasArkansas | $95.92 | — |
| ArizonaArizona | $101.29 | — |
| Bakersfield, CACalifornia | $107.73 | — |
| Chico, CACalifornia | $107.52 | — |
| El Centro, CACalifornia | $107.52 | — |
| Fresno, CACalifornia | $107.52 | — |
| Hanford, CACalifornia | $107.52 | — |
| Madera, CACalifornia | $107.52 | — |
| Merced, CACalifornia | $107.52 | — |
| Modesto, CACalifornia | $107.52 | — |
| Napa, CACalifornia | $120.03 | — |
| Oxnard, CACalifornia | $112.11 | — |
| Redding, CACalifornia | $107.52 | — |
| Rest of CaliforniaCalifornia | $107.52 | — |
| Riverside, CACalifornia | $108.00 | — |
| Sacramento, CACalifornia | $111.59 | — |
| Salinas, CACalifornia | $111.13 | — |
| San Diego, CACalifornia | $112.74 | — |
| Marin County, CACalifornia | $125.90 | — |
| San Francisco, CACalifornia | $125.85 | — |
| San Benito County, CACalifornia | $128.28 | — |
| Santa Clara County, CACalifornia | $128.10 | — |
| San Luis Obispo, CACalifornia | $109.44 | — |
| Santa Cruz, CACalifornia | $113.07 | — |
| Santa Maria, CACalifornia | $111.27 | — |
| Santa Rosa, CACalifornia | $114.16 | — |
| Stockton, CACalifornia | $107.52 | — |
| Vallejo, CACalifornia | $119.96 | — |
| Visalia, CACalifornia | $107.52 | — |
| Yuba City, CACalifornia | $107.52 | — |
| ColoradoColorado | $106.13 | — |
| ConnecticutConnecticut | $107.74 | — |
| DelawareDelaware | $102.49 | — |
| Fort Lauderdale, FLFlorida | $104.54 | — |
| Rest of FloridaFlorida | $101.58 | — |
| Hawaii, Guam, HIHawaii | $108.44 | — |
| IowaIowa | $98.26 | — |
| IdahoIdaho | $98.59 | — |
| East St. Louis, ILIllinois | $100.65 | — |
| Rest of IllinoisIllinois | $99.73 | — |
| Suburban Chicago, ILIllinois | $105.51 | — |
| IndianaIndiana | $98.92 | — |
| KansasKansas | $97.92 | — |
| KentuckyKentucky | $97.79 | — |
| New Orleans, LALouisiana | $100.42 | — |
| Rest of LouisianaLouisiana | $97.67 | — |
| Metropolitan Boston, MAMassachusetts | $113.74 | — |
| Rest of MassachusettsMassachusetts | $105.88 | — |
| Baltimore area, MDMaryland | $107.37 | — |
| Rest of MarylandMaryland | $103.87 | — |
| Rest of MaineMaine | $98.79 | — |
| Southern Maine, MEMaine | $101.98 | — |
| Detroit, MIMichigan | $102.22 | — |
| Rest of MichiganMichigan | $99.15 | — |
| MinnesotaMinnesota | $103.23 | — |
| Metropolitan Kansas City, MOMissouri | $100.11 | — |
| Metropolitan St. Louis, MOMissouri | $100.73 | — |
| Rest of MissouriMissouri | $96.66 | — |
| MississippiMississippi | $96.30 | — |
| MontanaMontana | $102.87 | — |
| North CarolinaNorth Carolina | $99.39 | — |
| North DakotaNorth Dakota | $102.08 | — |
| NebraskaNebraska | $98.60 | — |
| New HampshireNew Hampshire | $104.54 | — |
| Northern New JerseyNew Jersey | $113.70 | — |
| Rest of New JerseyNew Jersey | $109.39 | — |
| New MexicoNew Mexico | $99.43 | — |
| NevadaNevada | $102.70 | — |
| NYC suburbs and Long Island, NYNew York | $116.11 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $109.96 | — |
| Queens, NYNew York | $115.25 | — |
| Rest of New YorkNew York | $100.24 | — |
| OhioOhio | $98.99 | — |
| OklahomaOklahoma | $97.79 | — |
| Portland, OROregon | $108.41 | — |
| Rest of OregonOregon | $102.30 | — |
| Metropolitan Philadelphia, PAPennsylvania | $105.99 | — |
| Rest of PennsylvaniaPennsylvania | $99.13 | — |
| Puerto RicoPuerto Rico | $103.35 | — |
| Rhode IslandRhode Island | $105.29 | — |
| South CarolinaSouth Carolina | $99.27 | — |
| South DakotaSouth Dakota | $101.99 | — |
| TennesseeTennessee | $98.18 | — |
| Austin, TXTexas | $105.43 | — |
| Beaumont, TXTexas | $98.75 | — |
| Brazoria, TXTexas | $102.63 | — |
| Dallas, TXTexas | $103.02 | — |
| Fort Worth, TXTexas | $102.59 | — |
| Galveston, TXTexas | $102.79 | — |
| Houston, TXTexas | $103.52 | — |
| Rest of TexasTexas | $100.46 | — |
| UtahUtah | $100.05 | — |
| VirginiaVirginia | $101.72 | — |
| Virgin Islands, VIUnited States Virgin Islands | $103.35 | — |
| VermontVermont | $101.77 | — |
| Rest of WashingtonWashington | $105.67 | — |
| King County, WAWashington | $115.63 | — |
| WisconsinWisconsin | $100.07 | — |
| West VirginiaWest Virginia | $97.59 | — |
| WyomingWyoming | $102.53 | — |
96125 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.
$95.92
$133.57
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 | $133.57 | 1 |
| AL | $96.70 | 1 |
| AR | $95.92 | 1 |
| AZ | $101.29 | 1 |
| CA | $107.52–$128.28 | 29 |
| CO | $106.13 | 1 |
| CT | $107.74 | 1 |
| DC | $114.06 | 1 |
| DE | $102.49 | 1 |
| FL | $101.58–$106.75 | 3 |
| GA | $98.30–$104.03 | 2 |
| GU | $108.44 | 1 |
| HI | $108.44 | 1 |
| IA | $98.26 | 1 |
| ID | $98.59 | 1 |
| IL | $99.73–$105.51 | 4 |
| IN | $98.92 | 1 |
| KS | $97.92 | 1 |
| KY | $97.79 | 1 |
| LA | $97.67–$100.42 | 2 |
| MA | $105.88–$113.74 | 2 |
| MD | $103.87–$114.06 | 3 |
| ME | $98.79–$101.98 | 2 |
| MI | $99.15–$102.22 | 2 |
| MN | $103.23 | 1 |
| MO | $96.66–$100.73 | 3 |
| MS | $96.30 | 1 |
| MT | $102.87 | 1 |
| NC | $99.39 | 1 |
| ND | $102.08 | 1 |
| NE | $98.60 | 1 |
| NH | $104.54 | 1 |
| NJ | $109.39–$113.70 | 2 |
| NM | $99.43 | 1 |
| NV | $102.70 | 1 |
| NY | $100.24–$116.11 | 5 |
| OH | $98.99 | 1 |
| OK | $97.79 | 1 |
| OR | $102.30–$108.41 | 2 |
| PA | $99.13–$105.99 | 2 |
| PR | $103.35 | 1 |
| RI | $105.29 | 1 |
| SC | $99.27 | 1 |
| SD | $101.99 | 1 |
| TN | $98.18 | 1 |
| TX | $98.75–$105.43 | 8 |
| UT | $100.05 | 1 |
| VA | $101.72–$114.06 | 2 |
| VI | $103.35 | 1 |
| VT | $101.77 | 1 |
| WA | $105.67–$115.63 | 2 |
| WI | $100.07 | 1 |
| WV | $97.59 | 1 |
| WY | $102.53 | 1 |
How the 96125 rate is calculated
Each of 96125’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 · 96125
RVUs × geographic indexes × conversion factor
Work1.70
1.70 RVUs× 1.000 GPCI
Practice expense1.34
1.34 RVUs× 1.000 GPCI
Malpractice0.04
0.04 RVUs× 1.000 GPCI
Adjusted RVUs
3.0800
Conversion factor
$33.4009
Medicare rate
$102.87
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Atlanta, GA inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,753
- Code
- 96125
- Physician work
- 1.70
- Practice expense
- 1.34
- Malpractice
- 0.04
GPCI2026.csv
44
- Locality
- Atlanta, GA
- Physician work
- 1.003
- Practice expense
- 1.016
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.70 | × 1.003 | 1.7051 |
| Practice expense | 1.34 | × 1.016 | 1.3614 |
| Malpractice | 0.04 | × 1.201 | 0.0480 |
| Total RVUs | 3.1146 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Atlanta, GA$104.03
Office: (1.7 × 1.003 + 1.34 × 1.016 + 0.04 × 1.201) × $33.4009 = $104.03
Payment rules and modifiers for 96125
The CMS indicators that decide how 96125 is paid alongside other services.
CMS payment indicators · 96125
Cognitive testing, per qualified professional hour
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 5 | Therapy reduction: practice expense of the second and later units is reduced. |
| 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 | 7 | Therapy service: the split doesn’t apply. |
What modifiers do to the payment
Modifier CQ · payment effect
With and without the modifier
96125 without CQ · national office
$102.87
Cognitive testing, per qualified professional hour
96125-CQ · Allowed amount unchanged
$102.87
Medicare cuts its own payment by 15% after the patient’s 20% coinsurance; the allowed amount stays the same. On $100 allowed: $20 coinsurance, then Medicare pays $68 instead of $80.
How 96125 has changed in Atlanta, GA
96125 · Office / nonfacility
$104.03
Effective 2026-10-01
The base rate is $4.32 higher than on 2025-10-01, moving from $99.71 to $104.03 (4.3%).
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
$99.71changed to$104.03
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 1.33 changed to 1.34
- Malpractice RVU 0.05 changed to 0.04
- Work GPCI 1.000 changed to 1.003
- Practice expense GPCI 0.997 changed to 1.016
- Malpractice GPCI 1.128 changed to 1.201
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$102.32changed to$99.71
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 1.31 changed to 1.33
- Malpractice RVU 0.06 changed to 0.05
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$100.65changed to$102.32
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$103.30changed to$100.65
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 1.29 changed to 1.31
- Practice expense GPCI 0.998 changed to 0.997
- Malpractice GPCI 1.016 changed to 1.128
January 1, 2023
RVU23A
$105.51changed to$103.30
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 1.27 changed to 1.29
- Malpractice RVU 0.09 changed to 0.06
- Malpractice GPCI 0.904 changed to 1.016
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$106.73changed to$105.51
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 1.28 changed to 1.27
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$111.77changed to$106.73
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 1.32 changed to 1.28
- Malpractice RVU 0.08 changed to 0.09
- Malpractice GPCI 0.996 changed to 0.904
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$112.52changed to$111.77
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 1.35 changed to 1.32
- Malpractice RVU 0.07 changed to 0.08
- Practice expense GPCI 0.997 changed to 0.998
- Malpractice GPCI 1.088 changed to 0.996
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$121.01changed to$112.52
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 1.59 changed to 1.35
Held through RVU19B, RVU19C, RVU19D.
April 1, 2018
RVU18B
No ratechanged to$121.01
Held through RVU18C, RVU18D.
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.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $104.03 | Not available in this setting | RVU26D |
| 2026-07-01 | $104.03 | Not available in this setting | RVU26C |
| 2026-04-01 | $104.03 | Not available in this setting | RVU26B |
| 2026-01-01 | $104.03 | Not available in this setting | RVU26A |
| 2025-10-01 | $99.71 | Not available in this setting | RVU25D |
| 2025-07-01 | $99.71 | Not available in this setting | RVU25C |
| 2025-04-01 | $99.71 | Not available in this setting | RVU25B |
| 2025-01-01 | $99.71 | Not available in this setting | RVU25A |
| 2024-10-01 | $102.32 | Not available in this setting | RVU24D |
| 2024-07-01 | $102.32 | Not available in this setting | RVU24C |
| 2024-04-01 | $102.32 | Not available in this setting | RVU24B |
| 2024-03-09 | $102.32 | Not available in this setting | RVU24AR |
| 2024-01-01 | $100.65 | Not available in this setting | RVU24A |
| 2023-10-01 | $103.30 | Not available in this setting | RVU23D |
| 2023-07-01 | $103.30 | Not available in this setting | RVU23C |
| 2023-04-01 | $103.30 | Not available in this setting | RVU23B |
| 2023-01-01 | $103.30 | Not available in this setting | RVU23A |
| 2022-10-01 | $105.51 | Not available in this setting | RVU22D |
| 2022-07-01 | $105.51 | Not available in this setting | RVU22C |
| 2022-04-01 | $105.51 | Not available in this setting | RVU22B |
| 2022-01-01 | $105.51 | Not available in this setting | RVU22A |
| 2021-10-01 | $106.73 | Not available in this setting | RVU21D |
| 2021-07-01 | $106.73 | Not available in this setting | RVU21C |
| 2021-04-01 | $106.73 | Not available in this setting | RVU21B |
| 2021-01-01 | $106.73 | Not available in this setting | RVU21A |
| 2020-10-01 | $111.77 | Not available in this setting | RVU20D |
| 2020-07-01 | $111.77 | Not available in this setting | RVU20C |
| 2020-04-01 | $111.77 | Not available in this setting | RVU20B |
| 2020-01-01 | $111.77 | Not available in this setting | RVU20A |
| 2019-10-01 | $112.52 | Not available in this setting | RVU19D |
| 2019-07-01 | $112.52 | Not available in this setting | RVU19C |
| 2019-04-01 | $112.52 | Not available in this setting | RVU19B |
| 2019-01-01 | $112.52 | Not available in this setting | RVU19A |
| 2018-10-01 | $121.01 | Not available in this setting | RVU18D |
| 2018-07-01 | $121.01 | Not available in this setting | RVU18C |
| 2018-04-01 | $121.01 | Not available in this setting | RVU18B |
| 2018-01-01 | Rate data unavailable | Not available in this setting | RVU18AR1 |
| 2017-10-01 | Rate data unavailable | Not available in this setting | RVU17D |
| 2017-07-01 | Rate data unavailable | Not available in this setting | RVU17C |
| 2017-04-01 | Rate data unavailable | Not available in this setting | RVU17B |
| 2017-01-01 | Rate data unavailable | Not available in this setting | RVU17A |
| 2016-10-01 | Rate data unavailable | Not available in this setting | RVU16D |
| 2016-07-01 | Rate data unavailable | Not available in this setting | RVU16C |
| 2016-04-01 | Rate data unavailable | Not available in this setting | RVU16B |
| 2016-01-01 | Rate data unavailable | Not available in this setting | RVU16A |
| 2015-10-01 | Rate data unavailable | Not available in this setting | RVU15D |
| 2015-07-01 | Rate data unavailable | Not available in this setting | RVU15C |
| 2015-04-01 | Rate data unavailable | Not available in this setting | RVU15B |
| 2015-01-01 | Rate data unavailable | Not available in this setting | RVU15A |
| 2014-10-01 | Rate data unavailable | Not available in this setting | RVU14D |
| 2014-07-01 | Rate data unavailable | Not available in this setting | RVU14C |
| 2014-04-01 | Rate data unavailable | Not available in this setting | RVU14B |
| 2014-01-01 | Rate data unavailable | Not available in this setting | RVU14A |
| 2013-10-01 | Rate data unavailable | Not available in this setting | RVU13D |
| 2013-07-01 | Rate data unavailable | Not available in this setting | RVU13C |
| 2013-04-01 | Rate data unavailable | Not available in this setting | RVU13B |
| 2013-01-01 | Rate data unavailable | Not available in this setting | RVU13AR |
Where the Atlanta, GA rate applies
Atlanta, GA is a Medicare payment area, not a city. Our Census mapping connects it to 114 cities and communities in Georgia. Some span more than one payment area; confirm with the service ZIP.
- Atlanta
- Acworth
- Alpharetta
- 96125 in Auburn · multiple payment areas
- Austell
- Avondale Estates
- Ball Ground
- Belvedere Park
96125 billing questions
When should I use this instead of 96105?
Use 96125 for standardized cognitive performance testing. Code 96105 is for assessment focused on aphasia.
Does 96125 include interpreting the results and preparing the report?
Yes. Those activities are part of the service, along with administering the tests to the patient; do not separately report them as components of the same testing service.
Do I append modifier 26?
No. CMS identifies 96125 as a therapy service for which the professional-component modifier does not apply.
How do I support the number of units?
The code is reported per qualified professional hour. Document the time spent administering tests, interpreting results, and preparing the report.
How does the therapy multiple procedure reduction affect this code?
When 96125 is the second or a later therapy unit on the same day, CMS reduces its practice expense portion.
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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