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CPT code 96137: Test administration, additional physician/QHP time2026 Medicare rate & RVUs in North Carolina

Reports each additional 30 minutes of psychological or neuropsychological test administration and scoring performed by a physician or qualified health care professional.

CMS RVU26DEffective Oct 1, 2026One payment locality347.5K Medicare services in 2024

In North Carolina, Medicare pays $35.62 for 96137 in the office and $16.30 when it’s performed in a hospital or facility.

$35.62Office (non-facility)
$16.30Hospital or facility
−3.9%vs the national office rate ($37.07)

Check a contract rate as a % of Medicare · 96137 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 96137 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 96137 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 96137 covers

Code 96137 represents each additional 30 minutes of psychological or neuropsychological test administration and scoring by a physician or other qualified health care professional, after the initial 30 minutes. It fits standardized testing such as memory, attention, intellectual, or personality measures when a psychologist, neuropsychologist, or other eligible clinician personally administers and scores the tests. These services may occur in behavioral health, neurology, rehabilitation, or specialty assessment settings to evaluate concerns such as cognitive change, brain injury, or emotional functioning.

Report 96137 with 96136 for the same testing service; it is an add-on and is not reported by itself. CMS pays it within the primary procedure's global period. Documentation should identify the tests, the clinician who administered and scored them, and the time attributable to those tasks. Keep test administration and scoring time distinct from interpretation, integration, clinical decision-making, and reporting, which are evaluation services.

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 96137

Across 109 of 109 payment localities, the office rate for 96137 runs from $34.01 in Arkansas to $48.36 in Santa Clara County, CA. North Carolina pays $35.62. The RVUs are the same everywhere; the geographic indexes change the dollars.

96137 in North Carolina vs other payment areas
  1. North Carolina · this page$35.62
  2. Los Angeles, CA · California$41.68+$6.06
  3. Washington, DC area · District of Columbia$41.77+$6.15
  4. Miami, FL · Florida$37.97+$2.35
  5. Chicago, IL · Illinois$37.29+$1.67
  6. Manhattan, NY · New York$41.58+$5.96
  7. Alaska · Alaska$46.17+$10.55

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

Every other payment area

96137 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$34.36$16.24
ArkansasArkansas$34.01$16.23
ArizonaArizona$36.40$16.34
Bakersfield, CACalifornia$39.45$16.75
Chico, CACalifornia$39.42$16.72
El Centro, CACalifornia$39.42$16.72
Fresno, CACalifornia$39.42$16.72
Hanford, CACalifornia$39.42$16.72

96137 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.

$34.01

$46.17

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
96137 office rate range by state
State / territoryOffice rate rangeLocalities
AK$46.171
AL$34.361
AR$34.011
AZ$36.401
CA$39.42–$48.3629
CO$38.651
CT$39.051
DC$41.771
DE$36.891
FL$36.12–$37.973
GA$34.73–$37.472
GU$40.051
HI$40.051
IA$35.231
ID$35.341
IL$35.19–$37.774
IN$35.491
KS$34.991
KY$34.671
LA$34.58–$35.792
MA$38.47–$41.922
MD$37.49–$41.773
ME$35.34–$36.882
MI$35.19–$36.322
MN$37.701
MO$34.08–$36.033
MS$34.061
MT$37.071
NC$35.621
ND$37.071
NE$35.401
NH$37.971
NJ$39.69–$41.522
NM$35.271
NV$37.101
NY$35.99–$42.165
OH$35.191
OK$34.751
OR$36.99–$39.732
PA$35.29–$38.242
PR$37.311
RI$38.081
SC$35.421
SD$37.071
TN$35.101
TX$35.12–$38.368
UT$35.771
VA$36.71–$41.772
VI$37.311
VT$36.861
WA$38.43–$42.772
WI$36.161
WV$34.231
WY$37.071

See 96137 in every payment locality

How the 96137 rate is calculated

Each of 96137’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 · 96137

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.46

0.46 RVUs× 1.000 GPCI

Practice expense0.65

0.65 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

1.1100

Conversion factor

$33.4009

Medicare rate

$37.07

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

12,760

Code
96137
Physician work
0.46
Practice expense
0.65
Malpractice
0.00

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 96137 in North Carolina
ComponentRVULocality factorAdjusted
Physician work0.46× 1.0000.4600
Practice expense0.65× 0.9330.6065
Malpractice0.00× 0.6390.0000
Total RVUs1.0665
Conversion factor× 33.4009

Office rate, North Carolina$35.62

Office: (0.46 × 1 + 0.65 × 0.933 + 0 × 0.639) × $33.4009 = $35.62

Facility: (0.46 × 1 + 0.03 × 0.933 + 0 × 0.639) × $33.4009 = $16.30

Open 96137 in the RVU calculator

Payment rules and modifiers for 96137

The CMS indicators that decide how 96137 is paid alongside other services.

CMS payment indicators · 96137

Test administration, additional physician/QHP time

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 96137

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

Codes related to 96137
CodeHow it relatesOffice range, North Carolina
Primary code
96136Test administration, physician or QHP, first 30 minutesInitial physician/QHP test administration and scoring time for the same testing service.$41.86
Used instead
96139Psychology testing, technician, each additional 30 minutesReports additional administration and scoring time when performed by a technician.$33.03
Often billed with
96130Psychological evaluation, first hourPsychological test evaluation may be separately reported when performed for the same testing service.$120.46
96131Psychological testing, each additional hourAdditional psychological test evaluation time may accompany separately performed test administration and scoring.$85.00
96132Neuropsychological evaluation, first hourNeuropsychological test evaluation may be separately reported with the same testing service.$119.10
96133Neuropsychological evaluation, each additional hourAdditional neuropsychological test evaluation time may accompany separately performed test administration and scoring.$95.50

How 96137 has changed in North Carolina

96137 · Office / nonfacility

$35.62

Effective 2026-10-01

The base rate is $1.36 higher than on 2025-10-01, moving from $34.26 to $35.62 (4.0%).

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

    $34.26changed to$35.62

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.64 changed to 0.65
    • Malpractice RVU 0.01 changed to 0.00
    • 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

    $35.88changed to$34.26

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.66 changed to 0.64

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $35.29changed to$35.88

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $37.51changed to$35.29

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.69 changed to 0.66
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $38.64changed to$37.51

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice RVU 0.02 changed to 0.01
    • 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

    $39.94changed to$38.64

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.72 changed to 0.69

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $41.98changed to$39.94

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.74 changed to 0.72
    • 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

    $42.24changed to$41.98

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.75 changed to 0.74
    • 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$42.24

    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$35.62$16.30RVU26D
2026-07-01$35.62$16.30RVU26C
2026-04-01$35.62$16.30RVU26B
2026-01-01$35.62$16.30RVU26A
2025-10-01$34.26$16.89RVU25D
2025-07-01$34.26$16.89RVU25C
2025-04-01$34.26$16.89RVU25B
2025-01-01$34.26$16.89RVU25A
2024-10-01$35.88$17.38RVU24D
2024-07-01$35.88$17.38RVU24C
2024-04-01$35.88$17.38RVU24B
2024-03-09$35.88$17.38RVU24AR
2024-01-01$35.29$17.10RVU24A
2023-10-01$37.51$17.72RVU23D
2023-07-01$37.51$17.72RVU23C
2023-04-01$37.51$17.72RVU23B
2023-01-01$37.51$17.72RVU23A
2022-10-01$38.64$18.41RVU22D
2022-07-01$38.64$18.41RVU22C
2022-04-01$38.64$18.41RVU22B
2022-01-01$38.64$18.41RVU22A
2021-10-01$39.94$18.57RVU21D
2021-07-01$39.94$18.57RVU21C
2021-04-01$39.94$18.57RVU21B
2021-01-01$39.94$18.57RVU21A
2020-10-01$41.98$19.50RVU20D
2020-07-01$41.98$19.50RVU20C
2020-04-01$41.98$19.50RVU20B
2020-01-01$41.98$19.50RVU20A
2019-10-01$42.24$19.43RVU19D
2019-07-01$42.24$19.43RVU19C
2019-04-01$42.24$19.43RVU19B
2019-01-01$42.24$19.43RVU19A
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 96137 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

96137 billing questions

What primary code must accompany 96137?

Report 96137 with 96136 for the same psychological or neuropsychological testing service. It is an add-on code, not a stand-alone service.

How does 96137 differ from 96136?

96136 represents the initial 30 minutes of physician or qualified health care professional test administration and scoring. 96137 represents each additional 30 minutes.

When should 96139 be used instead?

Use 96139 for additional test administration and scoring time performed by a technician. 96137 is for time performed by a physician or other qualified health care professional.

Can test interpretation and the report be included in 96137 time?

96137 captures administration and scoring time. Interpretation, integration of results, clinical decision-making, and reporting are evaluation services, represented by codes such as 96130 or 96132.

What documentation supports reporting 96137?

Document the tests administered and scored, the clinician performing those tasks, and the time attributable to them. The record should support that this is additional time beyond the initial service reported with 96136.

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 96137PPRRVU2026_Oct_nonQPP.csv, line 12,760 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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