CPT code 96127: Behavioral screening tool, per scored standardized instrument2026 Medicare rate & RVUs in California
Administration and scoring of a brief standardized emotional or behavioral questionnaire, such as the PHQ-9 or GAD-7, reported per instrument administered and scored.
Medicare pays $5.30–$6.92 for 96127 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$5.30 to $6.92
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $5.33 | Unavailable |
| Chico, CA | $5.30 | Unavailable |
| El Centro, CA | $5.31 | Unavailable |
| Fresno, CA | $5.30 | Unavailable |
| Hanford, CA | $5.30 | Unavailable |
| Los Angeles, CA | $5.75 | Unavailable |
| Madera, CA | $5.30 | Unavailable |
| Marin County, CA | $6.75 | Unavailable |
| Merced, CA | $5.30 | Unavailable |
| Modesto, CA | $5.30 | Unavailable |
| Napa, CA | $6.33 | Unavailable |
| Oxnard, CA | $5.74 | Unavailable |
| Redding, CA | $5.30 | Unavailable |
| Rest of California | $5.30 | Unavailable |
| Riverside, CA | $5.41 | Unavailable |
| Sacramento, CA | $5.62 | Unavailable |
| Salinas, CA | $5.60 | Unavailable |
| San Benito County, CA | $6.92 | Unavailable |
| San Diego, CA | $5.77 | Unavailable |
| San Francisco, CA | $6.74 | Unavailable |
| San Luis Obispo, CA | $5.51 | Unavailable |
| Santa Clara County, CA | $6.88 | Unavailable |
| Santa Cruz, CA | $5.86 | Unavailable |
| Santa Maria, CA | $5.63 | Unavailable |
| Santa Rosa, CA | $5.92 | Unavailable |
| Stockton, CA | $5.30 | Unavailable |
| Vallejo, CA | $6.32 | Unavailable |
| Visalia, CA | $5.30 | Unavailable |
| Yuba City, CA | $5.30 | Unavailable |
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.
How the rate is built · 96127
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.14
0.14 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.1500
Conversion factor
$33.4009
Medicare rate
$5.01
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 96127
The CMS indicators that decide how 96127 is paid alongside other services.
CMS payment indicators · 96127
Behavioral screening tool, per scored standardized instrument
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| 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 | 3 | Technical component only. |
96127 compared with similar codes
Compare codes · National
5 codes, side by side
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.
96127 billing questions
How many units are reported when several screening tools are used at one visit?
Report one unit for each standardized instrument administered and scored. A repeat use of the same instrument needs a separate administration, scored result, and clinical purpose; rescoring one completed form does not support another unit.
Is the provider's review of the score billed separately?
96127 covers administration and scoring, not professional interpretation. CMS identifies separate coding for interpretation; routine use of the result during a visit does not, by itself, establish a separately reportable interpretation service.
Should maternal depression screening at an infant's well-child visit use this code?
Screening the parent for the child's benefit, for example with the Edinburgh Postnatal Depression Scale, is generally reported with caregiver-focused code 96161 rather than 96127.
What documentation supports each unit?
Identify the instrument, record who completed it and its score, and retain the scored form or result. Document the clinical response when indicated, such as a referral, medication change, or follow-up plan.
Can this be reported with a developmental screen at the same visit?
Yes, when separate instruments are administered and scored. A developmental tool such as the ASQ is reported with 96110, while a distinct emotional or behavioral tool is reported with 96127.
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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