FeeBase
Log inGet started
Menu

CPT code 96131: Psychological testing, each additional hour2026 Medicare rate & RVUs in North Carolina

Report 96131 for additional physician or qualified professional time interpreting psychological test findings, integrating clinical information, and preparing an evaluation after the initial hour.

CMS RVU26DEffective Oct 1, 2026One payment locality73.5K Medicare services in 2024

In North Carolina, Medicare pays $85.00 for 96131 in the office and $69.73 when it’s performed in a hospital or facility.

$85.00Office (non-facility)
$69.73Hospital or facility
−1.7%vs the national office rate ($86.51)

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.

We’ll open 96131 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 96131 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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 North Carolina 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. North Carolina pays $85.00. The RVUs are the same everywhere; the geographic indexes change the dollars.

96131 in North Carolina vs other payment areas
  1. North Carolina · this page$85.00
  2. Los Angeles, CA · California$92.87+$7.87
  3. Washington, DC area · District of Columbia$93.77+$8.77
  4. Miami, FL · Florida$87.87+$2.87
  5. Chicago, IL · Illinois$87.50+$2.50
  6. Manhattan, NY · New York$94.25+$9.25
  7. Alaska · Alaska$120.44+$35.44

Other areas in North Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

96131 in every other Medicare payment locality
Payment localityOfficeFacility
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

96131 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
96131 office rate range by state
State / territoryOffice rate rangeLocalities
AK$120.441
AL$83.771
AR$83.431
AZ$85.821
CA$89.45–$102.7129
CO$88.551
CT$89.481
DC$93.771
DE$86.551
FL$85.77–$87.873
GA$84.34–$87.102
GU$89.201
HI$89.201
IA$84.551
ID$84.681
IL$84.89–$87.784
IN$84.821
KS$84.351
KY$84.181
LA$84.11–$85.332
MA$88.59–$93.172
MD$87.38–$93.773
ME$84.73–$86.202
MI$84.75–$86.012
MN$86.871
MO$83.64–$85.513
MS$83.541
MT$86.511
NC$85.001
ND$86.311
NE$84.711
NH$87.321
NJ$91.06–$93.972
NM$84.861
NV$86.471
NY$85.37–$94.905
OH$84.711
OK$84.221
OR$86.33–$89.772
PA$84.79–$88.602
PR$86.731
RI$88.401
SC$84.881
SD$86.291
TN$84.471
TX$84.62–$87.808
UT$85.231
VA$86.06–$93.772
VI$86.731
VT$86.141
WA$88.38–$94.422
WI$85.411
WV$83.941
WY$86.421

See 96131 in every payment locality

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

Office or facility?

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 North Carolina 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

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 96131 in North Carolina
ComponentRVULocality factorAdjusted
Physician work1.96× 1.0001.9600
Practice expense0.62× 0.9330.5785
Malpractice0.01× 0.6390.0064
Total RVUs2.5448
Conversion factor× 33.4009

Office rate, North Carolina$85.00

Office: (1.96 × 1 + 0.62 × 0.933 + 0.01 × 0.639) × $33.4009 = $85.00

Facility: (1.96 × 1 + 0.13 × 0.933 + 0.01 × 0.639) × $33.4009 = $69.73

Open 96131 in the RVU calculator

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

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

Codes related to 96131

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

Codes related to 96131
CodeHow it relatesOffice range, North Carolina
Add-on codes
96130Psychological evaluation, first hourInitial-hour psychological testing evaluation code required with 96131.$120.46
Used instead
96132Neuropsychological evaluation, first hourInitial-hour code for neuropsychological testing evaluation rather than psychological testing evaluation.$119.10
96133Neuropsychological evaluation, each additional hourAdditional-hour neuropsychological evaluation code; use with 96132, not 96130.$95.50
Often billed with
96136Test administration, physician or QHP, first 30 minutesPhysician/QHP test administration and scoring may accompany evaluation when separately reportable.$41.86
96137Test administration, additional physician/QHP timeAdditional physician/QHP test administration and scoring may accompany evaluation when separately reportable.$35.62
96138Psychological testing, technician, first 30 minutesTechnician test administration and scoring may accompany evaluation when separately reportable.$35.12
96139Psychology testing, technician, each additional 30 minutesAdditional technician test administration and scoring may accompany evaluation when separately reportable.$33.03

How 96131 has changed in North Carolina

96131 · Office / nonfacility

$85.00

Effective 2026-10-01

The base rate is $3.97 higher than on 2025-10-01, moving from $81.03 to $85.00 (4.9%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $81.03changed to$85.00

    • 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
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $83.61changed to$81.03

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.05 changed to 0.04

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $82.25changed to$83.61

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $85.02changed to$82.25

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.04 changed to 0.05
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $88.36changed to$85.02

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice RVU 0.09 changed to 0.04
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $89.42changed to$88.36

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.57 changed to 0.56

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $91.65changed to$89.42

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.55 changed to 0.57
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $88.50changed to$91.65

    • 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
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    No ratechanged to$88.50

    Held through RVU19B, RVU19C, RVU19D.

  10. 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.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$85.00$69.73RVU26D
2026-07-01$85.00$69.73RVU26C
2026-04-01$85.00$69.73RVU26B
2026-01-01$85.00$69.73RVU26A
2025-10-01$81.03$71.45RVU25D
2025-07-01$81.03$71.45RVU25C
2025-04-01$81.03$71.45RVU25B
2025-01-01$81.03$71.45RVU25A
2024-10-01$83.61$73.75RVU24D
2024-07-01$83.61$73.75RVU24C
2024-04-01$83.61$73.75RVU24B
2024-03-09$83.61$73.75RVU24AR
2024-01-01$82.25$72.54RVU24A
2023-10-01$85.02$75.59RVU23D
2023-07-01$85.02$75.59RVU23C
2023-04-01$85.02$75.59RVU23B
2023-01-01$85.02$75.59RVU23A
2022-10-01$88.36$79.05RVU22D
2022-07-01$88.36$79.05RVU22C
2022-04-01$88.36$79.05RVU22B
2022-01-01$88.36$79.05RVU22A
2021-10-01$89.42$80.35RVU21D
2021-07-01$89.42$80.35RVU21C
2021-04-01$89.42$80.35RVU21B
2021-01-01$89.42$80.35RVU21A
2020-10-01$91.65$83.93RVU20D
2020-07-01$91.65$83.93RVU20C
2020-04-01$91.65$83.93RVU20B
2020-01-01$91.65$83.93RVU20A
2019-10-01$88.50$83.46RVU19D
2019-07-01$88.50$83.46RVU19C
2019-04-01$88.50$83.46RVU19B
2019-01-01$88.50$83.46RVU19A
2018-10-01Not in this releaseNot in this releaseRVU18D
2018-07-01Not in this releaseNot in this releaseRVU18C
2018-04-01Not in this releaseNot in this releaseRVU18B
2018-01-01Not in this releaseNot in this releaseRVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 96131 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

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
RVUs for 96131PPRRVU2026_Oct_nonQPP.csv, line 12,756 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 96131 pays in North Carolina?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 96131 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Build my fee sheet