CPT code 96125: Cognitive testing, per qualified professional hour2026 Medicare rate & RVUs in New Mexico
Report standardized cognitive performance testing when a qualified health professional administers tests, interprets results, and prepares a clinical report.
In New Mexico, Medicare pays $99.43 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 New Mexico 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. New Mexico pays $99.43. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$99.43
- Los Angeles, CA · California$112.94+$13.51
- Washington, DC area · District of Columbia$114.06+$14.63
- Miami, FL · Florida$106.75+$7.32
- Chicago, IL · Illinois$105.23+$5.80
- Manhattan, NY · New York$114.54+$15.11
- Alaska · Alaska$133.57+$34.14
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 | — |
| Atlanta, GAGeorgia | $104.03 | — |
| Rest of GeorgiaGeorgia | $98.30 | — |
| 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 | — |
| 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 New Mexico 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
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.70 | × 1.000 | 1.7000 |
| Practice expense | 1.34 | × 0.917 | 1.2288 |
| Malpractice | 0.04 | × 1.201 | 0.0480 |
| Total RVUs | 2.9768 | ||
| Conversion factor | × 33.4009 | ||
Office rate, New Mexico$99.43
Office: (1.7 × 1 + 1.34 × 0.917 + 0.04 × 1.201) × $33.4009 = $99.43
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 New Mexico
96125 · Office / nonfacility
$99.43
Effective 2026-10-01
The base rate is $3.48 higher than on 2025-10-01, moving from $95.95 to $99.43 (3.6%).
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
$95.95changed to$99.43
- 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
- Practice expense GPCI 0.908 changed to 0.917
- Malpractice GPCI 1.172 changed to 1.201
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$98.52changed to$95.95
- 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
$96.92changed to$98.52
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$99.42changed to$96.92
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 1.29 changed to 1.31
- Practice expense GPCI 0.902 changed to 0.908
- Malpractice GPCI 1.169 changed to 1.172
January 1, 2023
RVU23A
$101.84changed to$99.42
- 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
- Practice expense GPCI 0.896 changed to 0.902
- Malpractice GPCI 1.166 changed to 1.169
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$103.00changed to$101.84
- 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
$108.09changed to$103.00
- 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
- Practice expense GPCI 0.908 changed to 0.896
- Malpractice GPCI 1.207 changed to 1.166
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$109.22changed to$108.09
- 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 0.921 changed to 0.908
- Malpractice GPCI 1.247 changed to 1.207
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$117.06changed to$109.22
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 1.59 changed to 1.35
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$113.89changed to$117.06
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 1.51 changed to 1.59
- Practice expense GPCI 0.920 changed to 0.921
- Malpractice GPCI 1.204 changed to 1.247
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$114.45changed to$113.89
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 1.54 changed to 1.51
- Practice expense GPCI 0.919 changed to 0.920
- Malpractice GPCI 1.161 changed to 1.204
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$114.71changed to$114.45
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 1.51 changed to 1.54
- Malpractice RVU 0.09 changed to 0.07
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$114.14changed to$114.71
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$110.63changed to$114.14
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 1.43 changed to 1.51
- Malpractice RVU 0.07 changed to 0.09
- Practice expense GPCI 0.918 changed to 0.919
- Malpractice GPCI 1.079 changed to 1.161
Held through RVU15B.
January 1, 2014
RVU14A
$103.84changed to$110.63
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 1.40 changed to 1.43
- Practice expense GPCI 0.916 changed to 0.918
- Malpractice GPCI 0.997 changed to 1.079
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $103.84
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $99.43 | Not available in this setting | RVU26D |
| 2026-07-01 | $99.43 | Not available in this setting | RVU26C |
| 2026-04-01 | $99.43 | Not available in this setting | RVU26B |
| 2026-01-01 | $99.43 | Not available in this setting | RVU26A |
| 2025-10-01 | $95.95 | Not available in this setting | RVU25D |
| 2025-07-01 | $95.95 | Not available in this setting | RVU25C |
| 2025-04-01 | $95.95 | Not available in this setting | RVU25B |
| 2025-01-01 | $95.95 | Not available in this setting | RVU25A |
| 2024-10-01 | $98.52 | Not available in this setting | RVU24D |
| 2024-07-01 | $98.52 | Not available in this setting | RVU24C |
| 2024-04-01 | $98.52 | Not available in this setting | RVU24B |
| 2024-03-09 | $98.52 | Not available in this setting | RVU24AR |
| 2024-01-01 | $96.92 | Not available in this setting | RVU24A |
| 2023-10-01 | $99.42 | Not available in this setting | RVU23D |
| 2023-07-01 | $99.42 | Not available in this setting | RVU23C |
| 2023-04-01 | $99.42 | Not available in this setting | RVU23B |
| 2023-01-01 | $99.42 | Not available in this setting | RVU23A |
| 2022-10-01 | $101.84 | Not available in this setting | RVU22D |
| 2022-07-01 | $101.84 | Not available in this setting | RVU22C |
| 2022-04-01 | $101.84 | Not available in this setting | RVU22B |
| 2022-01-01 | $101.84 | Not available in this setting | RVU22A |
| 2021-10-01 | $103.00 | Not available in this setting | RVU21D |
| 2021-07-01 | $103.00 | Not available in this setting | RVU21C |
| 2021-04-01 | $103.00 | Not available in this setting | RVU21B |
| 2021-01-01 | $103.00 | Not available in this setting | RVU21A |
| 2020-10-01 | $108.09 | Not available in this setting | RVU20D |
| 2020-07-01 | $108.09 | Not available in this setting | RVU20C |
| 2020-04-01 | $108.09 | Not available in this setting | RVU20B |
| 2020-01-01 | $108.09 | Not available in this setting | RVU20A |
| 2019-10-01 | $109.22 | Not available in this setting | RVU19D |
| 2019-07-01 | $109.22 | Not available in this setting | RVU19C |
| 2019-04-01 | $109.22 | Not available in this setting | RVU19B |
| 2019-01-01 | $109.22 | Not available in this setting | RVU19A |
| 2018-10-01 | $117.06 | Not available in this setting | RVU18D |
| 2018-07-01 | $117.06 | Not available in this setting | RVU18C |
| 2018-04-01 | $117.06 | Not available in this setting | RVU18B |
| 2018-01-01 | $117.06 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $113.89 | Not available in this setting | RVU17D |
| 2017-07-01 | $113.89 | Not available in this setting | RVU17C |
| 2017-04-01 | $113.89 | Not available in this setting | RVU17B |
| 2017-01-01 | $113.89 | Not available in this setting | RVU17A |
| 2016-10-01 | $114.45 | Not available in this setting | RVU16D |
| 2016-07-01 | $114.45 | Not available in this setting | RVU16C |
| 2016-04-01 | $114.45 | Not available in this setting | RVU16B |
| 2016-01-01 | $114.45 | Not available in this setting | RVU16A |
| 2015-10-01 | $114.71 | Not available in this setting | RVU15D |
| 2015-07-01 | $114.71 | Not available in this setting | RVU15C |
| 2015-04-01 | $114.14 | Not available in this setting | RVU15B |
| 2015-01-01 | $114.14 | Not available in this setting | RVU15A |
| 2014-10-01 | $110.63 | Not available in this setting | RVU14D |
| 2014-07-01 | $110.63 | Not available in this setting | RVU14C |
| 2014-04-01 | $110.63 | Not available in this setting | RVU14B |
| 2014-01-01 | $110.63 | Not available in this setting | RVU14A |
| 2013-10-01 | $103.84 | Not available in this setting | RVU13D |
| 2013-07-01 | $103.84 | Not available in this setting | RVU13C |
| 2013-04-01 | $103.84 | Not available in this setting | RVU13B |
| 2013-01-01 | $103.84 | Not available in this setting | RVU13AR |
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
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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