CPT code 96127: Behavioral screening tool, per scored standardized instrument2026 Medicare rate & RVUs

Medicare pays $5.01 for 96127 nationally in the office. Local office rates run $4.19–$6.92.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 96127 covers

This service involves a brief standardized questionnaire used to screen for or monitor emotional and behavioral symptoms. Typical tools include the PHQ-9 or PHQ-A for depression, the GAD-7 for anxiety, Vanderbilt rating scales for ADHD, and the Pediatric Symptom Checklist. A patient, parent, or teacher may complete the form, and clinical staff commonly score it. It is used in primary care, pediatrics, and behavioral health practices during well visits, problem visits, and medication follow-ups, typically in an office setting.

Report one unit for each instrument administered, scored, and documented; a PHQ-9 and GAD-7 completed at one visit support two units. A repeat administration needs its own scored result and clinical purpose. The record should identify the instrument, its score, and any clinical response. CMS classifies 96127 as a technical-component-only code with no physician work value. It covers administration and scoring; separate coding covers interpretation when the requirements for that service are met. Do not append modifier 26 or TC to 96127.

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.

Where 96127 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

96127 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 96127 rate is calculated

Each of 96127’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.

Payment rules and modifiers for 96127

The CMS indicators that decide how 96127 is paid alongside other services.

96127 compared with similar codes

How to choose

96110Developmental screeningPer standardized instrument

Use 96110 for a developmental screening tool such as the ASQ. Use 96127 for an instrument assessing the patient's mood, anxiety, attention, or behavioral symptoms.

96146Automated testingSingle instrument, automated result

96146 covers a single psychological or neuropsychological test administered electronically with an automated result. 96127 covers a brief scored emotional or behavioral assessment.

96138Psychological testingTechnician, first 30 minutes

96138 covers the first 30 minutes of technician-administered and scored psychological or neuropsychological testing involving two or more tests. Report 96127 per brief standardized emotional or behavioral instrument, not by time.

96161Health risk assessmentCaregiver-focused instrument

96161 applies when the caregiver's own risk is assessed for the patient's benefit. 96127 applies when the instrument assesses the patient's own emotional or behavioral status.

Codes related to 96127

Related codes aren’t interchangeable: bill the code that matches the service 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

Open CMS sourceHow we calculate rates