CPT code 96137: Test administration, additional physician/QHP time2026 Medicare rate & RVUs in South Carolina
Reports each additional 30 minutes of psychological or neuropsychological test administration and scoring performed by a physician or qualified health care professional.
In South Carolina, Medicare pays $35.42 for 96137 in the office and $16.29 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 South 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. South Carolina pays $35.42. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Carolina · this page$35.42
- Los Angeles, CA · California$41.68+$6.26
- Washington, DC area · District of Columbia$41.77+$6.35
- Miami, FL · Florida$37.97+$2.55
- Chicago, IL · Illinois$37.29+$1.87
- Manhattan, NY · New York$41.58+$6.16
- Alaska · Alaska$46.17+$10.75
Other areas in South Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $39.42 | $16.72 |
| Merced, CACalifornia | $39.42 | $16.72 |
| Modesto, CACalifornia | $39.42 | $16.72 |
| Napa, CACalifornia | $44.95 | $17.65 |
| Oxnard, CACalifornia | $41.46 | $16.98 |
| Redding, CACalifornia | $39.42 | $16.72 |
| Rest of CaliforniaCalifornia | $39.42 | $16.72 |
| Riverside, CACalifornia | $39.44 | $16.74 |
| Sacramento, CACalifornia | $41.17 | $17.08 |
| Salinas, CACalifornia | $41.00 | $17.00 |
| San Diego, CACalifornia | $41.79 | $17.02 |
| Marin County, CACalifornia | $47.44 | $18.24 |
| San Francisco, CACalifornia | $47.44 | $18.24 |
| San Benito County, CACalifornia | $48.36 | $18.50 |
| Santa Clara County, CACalifornia | $48.36 | $18.50 |
| San Luis Obispo, CACalifornia | $40.35 | $16.77 |
| Santa Cruz, CACalifornia | $42.07 | $16.90 |
| Santa Maria, CACalifornia | $41.11 | $16.96 |
| Santa Rosa, CACalifornia | $42.49 | $17.06 |
| Stockton, CACalifornia | $39.42 | $16.72 |
| Vallejo, CACalifornia | $44.95 | $17.65 |
| Visalia, CACalifornia | $39.42 | $16.72 |
| Yuba City, CACalifornia | $39.42 | $16.72 |
| ColoradoColorado | $38.65 | $16.61 |
| ConnecticutConnecticut | $39.05 | $16.75 |
| DelawareDelaware | $36.89 | $16.43 |
| Fort Lauderdale, FLFlorida | $37.36 | $16.38 |
| Rest of FloridaFlorida | $36.12 | $16.32 |
| Atlanta, GAGeorgia | $37.47 | $16.43 |
| Rest of GeorgiaGeorgia | $34.73 | $16.26 |
| Hawaii, Guam, HIHawaii | $40.05 | $16.50 |
| IowaIowa | $35.23 | $16.28 |
| IdahoIdaho | $35.34 | $16.29 |
| East St. Louis, ILIllinois | $35.34 | $16.29 |
| Rest of IllinoisIllinois | $35.19 | $16.28 |
| Suburban Chicago, ILIllinois | $37.77 | $16.50 |
| IndianaIndiana | $35.49 | $16.29 |
| KansasKansas | $34.99 | $16.27 |
| KentuckyKentucky | $34.67 | $16.26 |
| New Orleans, LALouisiana | $35.79 | $16.31 |
| Rest of LouisianaLouisiana | $34.58 | $16.25 |
| Metropolitan Boston, MAMassachusetts | $41.92 | $17.19 |
| Rest of MassachusettsMassachusetts | $38.47 | $16.67 |
| Baltimore area, MDMaryland | $38.91 | $16.69 |
| Rest of MarylandMaryland | $37.49 | $16.53 |
| Rest of MaineMaine | $35.34 | $16.29 |
| Southern Maine, MEMaine | $36.88 | $16.36 |
| Detroit, MIMichigan | $36.32 | $16.33 |
| Rest of MichiganMichigan | $35.19 | $16.28 |
| MinnesotaMinnesota | $37.70 | $16.40 |
| Metropolitan Kansas City, MOMissouri | $35.75 | $16.31 |
| Metropolitan St. Louis, MOMissouri | $36.03 | $16.32 |
| Rest of MissouriMissouri | $34.08 | $16.23 |
| MississippiMississippi | $34.06 | $16.23 |
| MontanaMontana | $37.07 | $16.37 |
| North CarolinaNorth Carolina | $35.62 | $16.30 |
| North DakotaNorth Dakota | $37.07 | $16.37 |
| NebraskaNebraska | $35.40 | $16.29 |
| New HampshireNew Hampshire | $37.97 | $16.41 |
| Northern New JerseyNew Jersey | $41.52 | $17.49 |
| Rest of New JerseyNew Jersey | $39.69 | $17.07 |
| New MexicoNew Mexico | $35.27 | $16.28 |
| NevadaNevada | $37.10 | $16.37 |
| NYC suburbs and Long Island, NYNew York | $42.16 | $17.54 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $39.83 | $17.15 |
| Queens, NYNew York | $42.01 | $17.53 |
| Rest of New YorkNew York | $35.99 | $16.32 |
| OhioOhio | $35.19 | $16.28 |
| OklahomaOklahoma | $34.75 | $16.26 |
| Portland, OROregon | $39.73 | $16.72 |
| Rest of OregonOregon | $36.99 | $16.36 |
| Metropolitan Philadelphia, PAPennsylvania | $38.24 | $16.68 |
| Rest of PennsylvaniaPennsylvania | $35.29 | $16.28 |
| Puerto RicoPuerto Rico | $37.31 | $16.38 |
| Rhode IslandRhode Island | $38.08 | $16.69 |
| South DakotaSouth Dakota | $37.07 | $16.37 |
| TennesseeTennessee | $35.10 | $16.28 |
| Austin, TXTexas | $38.36 | $16.46 |
| Beaumont, TXTexas | $35.12 | $16.28 |
| Brazoria, TXTexas | $37.00 | $16.48 |
| Dallas, TXTexas | $37.13 | $16.50 |
| Fort Worth, TXTexas | $36.91 | $16.49 |
| Galveston, TXTexas | $37.05 | $16.48 |
| Houston, TXTexas | $37.05 | $16.48 |
| Rest of TexasTexas | $35.97 | $16.32 |
| UtahUtah | $35.77 | $16.31 |
| VirginiaVirginia | $36.71 | $16.35 |
| Virgin Islands, VIUnited States Virgin Islands | $37.31 | $16.38 |
| VermontVermont | $36.86 | $16.36 |
| Rest of WashingtonWashington | $38.43 | $16.62 |
| King County, WAWashington | $42.77 | $17.36 |
| WisconsinWisconsin | $36.16 | $16.32 |
| West VirginiaWest Virginia | $34.23 | $16.24 |
| WyomingWyoming | $37.07 | $16.37 |
96137 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.
$34.01
$46.17
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 | $46.17 | 1 |
| AL | $34.36 | 1 |
| AR | $34.01 | 1 |
| AZ | $36.40 | 1 |
| CA | $39.42–$48.36 | 29 |
| CO | $38.65 | 1 |
| CT | $39.05 | 1 |
| DC | $41.77 | 1 |
| DE | $36.89 | 1 |
| FL | $36.12–$37.97 | 3 |
| GA | $34.73–$37.47 | 2 |
| GU | $40.05 | 1 |
| HI | $40.05 | 1 |
| IA | $35.23 | 1 |
| ID | $35.34 | 1 |
| IL | $35.19–$37.77 | 4 |
| IN | $35.49 | 1 |
| KS | $34.99 | 1 |
| KY | $34.67 | 1 |
| LA | $34.58–$35.79 | 2 |
| MA | $38.47–$41.92 | 2 |
| MD | $37.49–$41.77 | 3 |
| ME | $35.34–$36.88 | 2 |
| MI | $35.19–$36.32 | 2 |
| MN | $37.70 | 1 |
| MO | $34.08–$36.03 | 3 |
| MS | $34.06 | 1 |
| MT | $37.07 | 1 |
| NC | $35.62 | 1 |
| ND | $37.07 | 1 |
| NE | $35.40 | 1 |
| NH | $37.97 | 1 |
| NJ | $39.69–$41.52 | 2 |
| NM | $35.27 | 1 |
| NV | $37.10 | 1 |
| NY | $35.99–$42.16 | 5 |
| OH | $35.19 | 1 |
| OK | $34.75 | 1 |
| OR | $36.99–$39.73 | 2 |
| PA | $35.29–$38.24 | 2 |
| PR | $37.31 | 1 |
| RI | $38.08 | 1 |
| SC | $35.42 | 1 |
| SD | $37.07 | 1 |
| TN | $35.10 | 1 |
| TX | $35.12–$38.36 | 8 |
| UT | $35.77 | 1 |
| VA | $36.71–$41.77 | 2 |
| VI | $37.31 | 1 |
| VT | $36.86 | 1 |
| WA | $38.43–$42.77 | 2 |
| WI | $36.16 | 1 |
| WV | $34.23 | 1 |
| WY | $37.07 | 1 |
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
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 South 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
93
- Locality
- South Carolina
- Physician work
- 1.000
- Practice expense
- 0.924
- Malpractice
- 0.850
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.46 | × 1.000 | 0.4600 |
| Practice expense | 0.65 | × 0.924 | 0.6006 |
| Malpractice | 0.00 | × 0.850 | 0.0000 |
| Total RVUs | 1.0606 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Carolina$35.42
Office: (0.46 × 1 + 0.65 × 0.924 + 0 × 0.85) × $33.4009 = $35.42
Facility: (0.46 × 1 + 0.03 × 0.924 + 0 × 0.85) × $33.4009 = $16.29
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
| 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 96137 has changed in South Carolina
96137 · Office / nonfacility
$35.42
Effective 2026-10-01
The base rate is $1.38 higher than on 2025-10-01, moving from $34.04 to $35.42 (4.1%).
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
$34.04changed to$35.42
- 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 0.913 changed to 0.924
- Malpractice GPCI 0.817 changed to 0.850
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$35.64changed to$34.04
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.66 changed to 0.64
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$35.06changed to$35.64
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$37.08changed to$35.06
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.69 changed to 0.66
- Practice expense GPCI 0.908 changed to 0.913
- Malpractice GPCI 0.756 changed to 0.817
January 1, 2023
RVU23A
$37.96changed to$37.08
- Conversion factor 34.6062 changed to 33.8872
- Malpractice RVU 0.02 changed to 0.01
- Practice expense GPCI 0.903 changed to 0.908
- Malpractice GPCI 0.695 changed to 0.756
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$39.22changed to$37.96
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.72 changed to 0.69
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$41.27changed to$39.22
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.74 changed to 0.72
- Practice expense GPCI 0.907 changed to 0.903
- Malpractice GPCI 0.624 changed to 0.695
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$41.63changed to$41.27
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.75 changed to 0.74
- Practice expense GPCI 0.912 changed to 0.907
- Malpractice GPCI 0.553 changed to 0.624
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
No ratechanged to$41.63
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 | $35.42 | $16.29 | RVU26D |
| 2026-07-01 | $35.42 | $16.29 | RVU26C |
| 2026-04-01 | $35.42 | $16.29 | RVU26B |
| 2026-01-01 | $35.42 | $16.29 | RVU26A |
| 2025-10-01 | $34.04 | $16.92 | RVU25D |
| 2025-07-01 | $34.04 | $16.92 | RVU25C |
| 2025-04-01 | $34.04 | $16.92 | RVU25B |
| 2025-01-01 | $34.04 | $16.92 | RVU25A |
| 2024-10-01 | $35.64 | $17.41 | RVU24D |
| 2024-07-01 | $35.64 | $17.41 | RVU24C |
| 2024-04-01 | $35.64 | $17.41 | RVU24B |
| 2024-03-09 | $35.64 | $17.41 | RVU24AR |
| 2024-01-01 | $35.06 | $17.12 | RVU24A |
| 2023-10-01 | $37.08 | $17.69 | RVU23D |
| 2023-07-01 | $37.08 | $17.69 | RVU23C |
| 2023-04-01 | $37.08 | $17.69 | RVU23B |
| 2023-01-01 | $37.08 | $17.69 | RVU23A |
| 2022-10-01 | $37.96 | $18.27 | RVU22D |
| 2022-07-01 | $37.96 | $18.27 | RVU22C |
| 2022-04-01 | $37.96 | $18.27 | RVU22B |
| 2022-01-01 | $37.96 | $18.27 | RVU22A |
| 2021-10-01 | $39.22 | $18.43 | RVU21D |
| 2021-07-01 | $39.22 | $18.43 | RVU21C |
| 2021-04-01 | $39.22 | $18.43 | RVU21B |
| 2021-01-01 | $39.22 | $18.43 | RVU21A |
| 2020-10-01 | $41.27 | $19.34 | RVU20D |
| 2020-07-01 | $41.27 | $19.34 | RVU20C |
| 2020-04-01 | $41.27 | $19.34 | RVU20B |
| 2020-01-01 | $41.27 | $19.34 | RVU20A |
| 2019-10-01 | $41.63 | $19.28 | RVU19D |
| 2019-07-01 | $41.63 | $19.28 | RVU19C |
| 2019-04-01 | $41.63 | $19.28 | RVU19B |
| 2019-01-01 | $41.63 | $19.28 | 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 South Carolina rate applies
South Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 475 cities and communities in South Carolina. Some span more than one payment area; confirm with the service ZIP.
- Abbeville
- Abney Crossroads
- Adams Run
- Aiken
- Alcolu
- Allendale
- Anderson
- Andrews
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
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