CPT code 96131: Psychological testing, each additional hour2026 Medicare rate & RVUs in Connecticut
Report 96131 for additional physician or qualified professional time interpreting psychological test findings, integrating clinical information, and preparing an evaluation after the initial hour.
In Connecticut, Medicare pays $89.48 for 96131 in the office and $71.86 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 96131 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 96131 covers
96131 represents additional physician or qualified health professional time for psychological testing evaluation after the initial hour. The clinician integrates test results with interview findings, records, and other clinical information; interprets findings; makes clinical decisions; develops treatment recommendations; and prepares a report. Feedback to the patient, family, or caregiver is part of the evaluation when performed. Psychologists and other qualified professionals use this service in office and facility settings to address diagnostic questions involving emotional, behavioral, personality, or intellectual functioning.
Report 96131 only with 96130, which represents the initial hour. Choose additional units based on documented evaluation time, not the number of tests or instruments; the record should support the professional work performed and the resulting report. CMS identifies this add-on as paid within the primary procedure's global period. Test administration and scoring are distinct work from evaluation and may be reported with the applicable administration codes when their requirements are met.
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 Connecticut compares for 96131
Across 109 of 109 payment localities, the office rate for 96131 runs from $83.43 in Arkansas to $120.44 in Alaska. Connecticut pays $89.48. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Connecticut · this page$89.48
- Los Angeles, CA · California$92.87+$3.39
- Washington, DC area · District of Columbia$93.77+$4.29
- Miami, FL · Florida$87.87−$1.61
- Chicago, IL · Illinois$87.50−$1.98
- Manhattan, NY · New York$94.25+$4.77
- Alaska · Alaska$120.44+$30.96
Other areas in Connecticut first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $83.77 | $69.45 |
| ArkansasArkansas | $83.43 | $69.37 |
| ArizonaArizona | $85.82 | $69.96 |
| Bakersfield, CACalifornia | $89.61 | $71.67 |
| Chico, CACalifornia | $89.45 | $71.52 |
| El Centro, CACalifornia | $89.46 | $71.52 |
| Fresno, CACalifornia | $89.45 | $71.52 |
| Hanford, CACalifornia | $89.45 | $71.52 |
| Madera, CACalifornia | $89.45 | $71.52 |
| Merced, CACalifornia | $89.45 | $71.52 |
| Modesto, CACalifornia | $89.45 | $71.52 |
| Napa, CACalifornia | $97.05 | $75.48 |
| Oxnard, CACalifornia | $91.98 | $72.64 |
| Redding, CACalifornia | $89.45 | $71.52 |
| Rest of CaliforniaCalifornia | $89.45 | $71.52 |
| Riverside, CACalifornia | $89.63 | $71.69 |
| Sacramento, CACalifornia | $92.09 | $73.05 |
| Salinas, CACalifornia | $91.68 | $72.71 |
| San Diego, CACalifornia | $92.38 | $72.80 |
| Marin County, CACalifornia | $101.04 | $77.96 |
| San Francisco, CACalifornia | $101.03 | $77.95 |
| San Benito County, CACalifornia | $102.71 | $79.11 |
| Santa Clara County, CACalifornia | $102.66 | $79.06 |
| San Luis Obispo, CACalifornia | $90.34 | $71.70 |
| Santa Cruz, CACalifornia | $92.18 | $72.30 |
| Santa Maria, CACalifornia | $91.62 | $72.54 |
| Santa Rosa, CACalifornia | $93.04 | $72.94 |
| Stockton, CACalifornia | $89.45 | $71.52 |
| Vallejo, CACalifornia | $97.04 | $75.47 |
| Visalia, CACalifornia | $89.45 | $71.52 |
| Yuba City, CACalifornia | $89.45 | $71.52 |
| ColoradoColorado | $88.55 | $71.13 |
| DelawareDelaware | $86.55 | $70.38 |
| Fort Lauderdale, FLFlorida | $87.05 | $70.47 |
| Rest of FloridaFlorida | $85.77 | $70.12 |
| Atlanta, GAGeorgia | $87.10 | $70.47 |
| Rest of GeorgiaGeorgia | $84.34 | $69.74 |
| Hawaii, Guam, HIHawaii | $89.20 | $70.60 |
| IowaIowa | $84.55 | $69.57 |
| IdahoIdaho | $84.68 | $69.62 |
| East St. Louis, ILIllinois | $85.19 | $70.13 |
| Rest of IllinoisIllinois | $84.89 | $69.95 |
| Suburban Chicago, ILIllinois | $87.78 | $70.98 |
| IndianaIndiana | $84.82 | $69.65 |
| KansasKansas | $84.35 | $69.56 |
| KentuckyKentucky | $84.18 | $69.63 |
| New Orleans, LALouisiana | $85.33 | $69.93 |
| Rest of LouisianaLouisiana | $84.11 | $69.63 |
| Metropolitan Boston, MAMassachusetts | $93.17 | $73.63 |
| Rest of MassachusettsMassachusetts | $88.59 | $71.35 |
| Baltimore area, MDMaryland | $89.15 | $71.59 |
| Rest of MarylandMaryland | $87.38 | $70.82 |
| Rest of MaineMaine | $84.73 | $69.67 |
| Southern Maine, MEMaine | $86.20 | $69.98 |
| Detroit, MIMichigan | $86.01 | $70.22 |
| Rest of MichiganMichigan | $84.75 | $69.81 |
| MinnesotaMinnesota | $86.87 | $70.03 |
| Metropolitan Kansas City, MOMissouri | $85.24 | $69.87 |
| Metropolitan St. Louis, MOMissouri | $85.51 | $69.93 |
| Rest of MissouriMissouri | $83.64 | $69.53 |
| MississippiMississippi | $83.54 | $69.45 |
| MontanaMontana | $86.51 | $70.14 |
| North CarolinaNorth Carolina | $85.00 | $69.73 |
| North DakotaNorth Dakota | $86.31 | $69.94 |
| NebraskaNebraska | $84.71 | $69.60 |
| New HampshireNew Hampshire | $87.32 | $70.28 |
| Northern New JerseyNew Jersey | $93.97 | $74.98 |
| Rest of New JerseyNew Jersey | $91.06 | $73.19 |
| New MexicoNew Mexico | $84.86 | $69.85 |
| NevadaNevada | $86.47 | $70.09 |
| NYC suburbs and Long Island, NYNew York | $94.90 | $75.44 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $91.49 | $73.57 |
| Queens, NYNew York | $94.61 | $75.27 |
| Rest of New YorkNew York | $85.37 | $69.83 |
| OhioOhio | $84.71 | $69.77 |
| OklahomaOklahoma | $84.22 | $69.60 |
| Portland, OROregon | $89.77 | $71.59 |
| Rest of OregonOregon | $86.33 | $70.03 |
| Metropolitan Philadelphia, PAPennsylvania | $88.60 | $71.56 |
| Rest of PennsylvaniaPennsylvania | $84.79 | $69.77 |
| Puerto RicoPuerto Rico | $86.73 | $70.18 |
| Rhode IslandRhode Island | $88.40 | $71.49 |
| South CarolinaSouth Carolina | $84.88 | $69.76 |
| South DakotaSouth Dakota | $86.29 | $69.92 |
| TennesseeTennessee | $84.47 | $69.59 |
| Austin, TXTexas | $87.80 | $70.49 |
| Beaumont, TXTexas | $84.62 | $69.73 |
| Brazoria, TXTexas | $86.77 | $70.55 |
| Dallas, TXTexas | $86.97 | $70.67 |
| Fort Worth, TXTexas | $86.76 | $70.63 |
| Galveston, TXTexas | $86.83 | $70.58 |
| Houston, TXTexas | $87.01 | $70.76 |
| Rest of TexasTexas | $85.42 | $69.89 |
| UtahUtah | $85.23 | $69.85 |
| VirginiaVirginia | $86.06 | $69.97 |
| Virgin Islands, VIUnited States Virgin Islands | $86.73 | $70.18 |
| VermontVermont | $86.14 | $69.93 |
| Rest of WashingtonWashington | $88.38 | $71.14 |
| King County, WAWashington | $94.42 | $74.34 |
| WisconsinWisconsin | $85.41 | $69.73 |
| West VirginiaWest Virginia | $83.94 | $69.72 |
| WyomingWyoming | $86.42 | $70.06 |
96131 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.
$83.43
$120.44
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 | $120.44 | 1 |
| AL | $83.77 | 1 |
| AR | $83.43 | 1 |
| AZ | $85.82 | 1 |
| CA | $89.45–$102.71 | 29 |
| CO | $88.55 | 1 |
| CT | $89.48 | 1 |
| DC | $93.77 | 1 |
| DE | $86.55 | 1 |
| FL | $85.77–$87.87 | 3 |
| GA | $84.34–$87.10 | 2 |
| GU | $89.20 | 1 |
| HI | $89.20 | 1 |
| IA | $84.55 | 1 |
| ID | $84.68 | 1 |
| IL | $84.89–$87.78 | 4 |
| IN | $84.82 | 1 |
| KS | $84.35 | 1 |
| KY | $84.18 | 1 |
| LA | $84.11–$85.33 | 2 |
| MA | $88.59–$93.17 | 2 |
| MD | $87.38–$93.77 | 3 |
| ME | $84.73–$86.20 | 2 |
| MI | $84.75–$86.01 | 2 |
| MN | $86.87 | 1 |
| MO | $83.64–$85.51 | 3 |
| MS | $83.54 | 1 |
| MT | $86.51 | 1 |
| NC | $85.00 | 1 |
| ND | $86.31 | 1 |
| NE | $84.71 | 1 |
| NH | $87.32 | 1 |
| NJ | $91.06–$93.97 | 2 |
| NM | $84.86 | 1 |
| NV | $86.47 | 1 |
| NY | $85.37–$94.90 | 5 |
| OH | $84.71 | 1 |
| OK | $84.22 | 1 |
| OR | $86.33–$89.77 | 2 |
| PA | $84.79–$88.60 | 2 |
| PR | $86.73 | 1 |
| RI | $88.40 | 1 |
| SC | $84.88 | 1 |
| SD | $86.29 | 1 |
| TN | $84.47 | 1 |
| TX | $84.62–$87.80 | 8 |
| UT | $85.23 | 1 |
| VA | $86.06–$93.77 | 2 |
| VI | $86.73 | 1 |
| VT | $86.14 | 1 |
| WA | $88.38–$94.42 | 2 |
| WI | $85.41 | 1 |
| WV | $83.94 | 1 |
| WY | $86.42 | 1 |
How the 96131 rate is calculated
Each of 96131’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 · 96131
RVUs × geographic indexes × conversion factor
Work1.96
1.96 RVUs× 1.000 GPCI
Practice expense0.62
0.62 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
2.5900
Conversion factor
$33.4009
Medicare rate
$86.51
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Connecticut inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,756
- Code
- 96131
- Physician work
- 1.96
- Practice expense
- 0.62
- Malpractice
- 0.01
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.96 | × 1.020 | 1.9992 |
| Practice expense | 0.62 | × 1.077 | 0.6677 |
| Malpractice | 0.01 | × 1.210 | 0.0121 |
| Total RVUs | 2.6790 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Connecticut$89.48
Office: (1.96 × 1.02 + 0.62 × 1.077 + 0.01 × 1.21) × $33.4009 = $89.48
Facility: (1.96 × 1.02 + 0.13 × 1.077 + 0.01 × 1.21) × $33.4009 = $71.86
Payment rules and modifiers for 96131
The CMS indicators that decide how 96131 is paid alongside other services.
CMS payment indicators · 96131
Psychological testing, each additional hour
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| 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 | 0 | Physician service: no professional/technical split. |
How 96131 has changed in Connecticut
96131 · Office / nonfacility
$89.48
Effective 2026-10-01
The base rate is $3.36 higher than on 2025-10-01, moving from $86.12 to $89.48 (3.9%).
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
$86.12changed to$89.48
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.56 changed to 0.62
- Malpractice RVU 0.04 changed to 0.01
- Work GPCI 1.022 changed to 1.020
- Practice expense GPCI 1.091 changed to 1.077
- Malpractice GPCI 1.207 changed to 1.210
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$89.03changed to$86.12
- Conversion factor 33.2875 changed to 32.3465
- Malpractice RVU 0.05 changed to 0.04
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$87.57changed to$89.03
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$90.77changed to$87.57
- Conversion factor 33.8872 changed to 32.7442
- Malpractice RVU 0.04 changed to 0.05
- Work GPCI 1.030 changed to 1.022
- Practice expense GPCI 1.102 changed to 1.091
- Malpractice GPCI 1.070 changed to 1.207
January 1, 2023
RVU23A
$94.84changed to$90.77
- Conversion factor 34.6062 changed to 33.8872
- Malpractice RVU 0.09 changed to 0.04
- Work GPCI 1.037 changed to 1.030
- Practice expense GPCI 1.114 changed to 1.102
- Malpractice GPCI 0.934 changed to 1.070
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$96.01changed to$94.84
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.57 changed to 0.56
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$98.43changed to$96.01
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.55 changed to 0.57
- Work GPCI 1.029 changed to 1.037
- Practice expense GPCI 1.113 changed to 1.114
- Malpractice GPCI 1.094 changed to 0.934
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$94.52changed to$98.43
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.48 changed to 0.55
- Malpractice RVU 0.07 changed to 0.09
- Work GPCI 1.021 changed to 1.029
- Practice expense GPCI 1.112 changed to 1.113
- Malpractice GPCI 1.255 changed to 1.094
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
No ratechanged to$94.52
Held through RVU19B, RVU19C, RVU19D.
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.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $89.48 | $71.86 | RVU26D |
| 2026-07-01 | $89.48 | $71.86 | RVU26C |
| 2026-04-01 | $89.48 | $71.86 | RVU26B |
| 2026-01-01 | $89.48 | $71.86 | RVU26A |
| 2025-10-01 | $86.12 | $74.83 | RVU25D |
| 2025-07-01 | $86.12 | $74.83 | RVU25C |
| 2025-04-01 | $86.12 | $74.83 | RVU25B |
| 2025-01-01 | $86.12 | $74.83 | RVU25A |
| 2024-10-01 | $89.03 | $77.40 | RVU24D |
| 2024-07-01 | $89.03 | $77.40 | RVU24C |
| 2024-04-01 | $89.03 | $77.40 | RVU24B |
| 2024-03-09 | $89.03 | $77.40 | RVU24AR |
| 2024-01-01 | $87.57 | $76.14 | RVU24A |
| 2023-10-01 | $90.77 | $79.57 | RVU23D |
| 2023-07-01 | $90.77 | $79.57 | RVU23C |
| 2023-04-01 | $90.77 | $79.57 | RVU23B |
| 2023-01-01 | $90.77 | $79.57 | RVU23A |
| 2022-10-01 | $94.84 | $83.66 | RVU22D |
| 2022-07-01 | $94.84 | $83.66 | RVU22C |
| 2022-04-01 | $94.84 | $83.66 | RVU22B |
| 2022-01-01 | $94.84 | $83.66 | RVU22A |
| 2021-10-01 | $96.01 | $85.13 | RVU21D |
| 2021-07-01 | $96.01 | $85.13 | RVU21C |
| 2021-04-01 | $96.01 | $85.13 | RVU21B |
| 2021-01-01 | $96.01 | $85.13 | RVU21A |
| 2020-10-01 | $98.43 | $89.19 | RVU20D |
| 2020-07-01 | $98.43 | $89.19 | RVU20C |
| 2020-04-01 | $98.43 | $89.19 | RVU20B |
| 2020-01-01 | $98.43 | $89.19 | RVU20A |
| 2019-10-01 | $94.52 | $88.51 | RVU19D |
| 2019-07-01 | $94.52 | $88.51 | RVU19C |
| 2019-04-01 | $94.52 | $88.51 | RVU19B |
| 2019-01-01 | $94.52 | $88.51 | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Connecticut rate applies
Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.
- Ansonia
- Ball Pond
- Baltic
- Bantam
- Bethel
- Bethlehem Village
- Bigelow Corners
- Blue Hills
96131 billing questions
Can 96131 be reported by itself?
No. It is an add-on code and must be reported with 96130 for the initial hour of psychological testing evaluation.
How is the number of 96131 units determined?
Use the documented additional evaluation time, rather than the number of tests administered. The record should support the time spent on interpretation, integration, clinical decision-making, recommendations, and reporting.
Does 96131 include test administration and scoring?
No. Evaluation work is distinct from administering and scoring tests. When separately reportable, administration and scoring use the applicable physician/QHP or technician codes.
How does 96131 differ from 96133?
96131 is additional time for psychological testing evaluation. 96133 is additional time for neuropsychological testing evaluation, paired with its own initial-hour code, 96132.
What documentation supports 96131?
Document the additional professional evaluation time and the work performed, such as integrating test findings with clinical information, interpreting results, developing recommendations, and completing the report.
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
Fee sheets · Coming soon
Put 96131 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
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