CPT 96105: Aphasia assessmentMedicare rate & RVUs

Medicare pays $97.20 for 96105 nationally in the office. Local office rates run $91.16–$128.08.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 96105 covers

A speech-language pathologist commonly performs this assessment when a patient has difficulty communicating after a stroke, brain injury, or another neurologic condition. The evaluation focuses on language abilities affected by aphasia, such as understanding or expressing spoken or written language. It may use structured tasks or standardized assessment tools, with results interpreted in the context of the patient’s communication needs.

Report 96105 for the assessment service on an hourly basis. Documentation should identify the language functions assessed, the methods or tools used, the findings, and the time spent on the assessment. Interpretation and the resulting report are part of this service, rather than separate 96105 units. CMS prices the code through the physician fee schedule; the code’s hourly basis and the documented service support its reporting.

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 96105 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

96105 rates by state

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

How the 96105 rate is calculated

Each of 96105’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.

Payment rules and modifiers for 96105

96105 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

96105 compared with similar codes

How to choose

96125Cognitive testing

96105 is for an aphasia-focused language assessment; 96125 is used for cognitive testing by a health professional.

96116Neurobehavioral exam

96105 evaluates language impairment associated with aphasia. 96116 concerns a broader neurobehavioral status examination.

92523Speech-language evaluation

Choose 92523 for an evaluation of speech sound production and language comprehension or expression; choose 96105 when the assessment is specifically for aphasia.

Codes related to 96105

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

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

Open CMS sourceHow we calculate rates