Billing code 96133: Neuropsychological evaluationMedicare rate & RVUs
Reports additional physician or qualified health care professional time integrating neuropsychological data, interpreting results, making clinical decisions, and preparing a report.
Medicare pays $97.86 for 96133 nationally in the office and $70.48 in a hospital or facility. Local office rates run $93.07–$132.36.
Medicare rate · 96133
Neuropsychological evaluation
Swap in your local Medicare rate.
- Work RVUs
- 1.96
- Total RVUs
- 2.93
- Global days
- ZZZ
National rate · 2026
$97.86
Office setting, before claim adjustments.
See every locality for 96133 → · Billed by an NP, PA or therapist? →
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 10 sections
What 96133 covers
A neuropsychologist, clinical psychologist, or other qualified health care professional uses this code for additional time evaluating neuropsychological test findings and related clinical information. The work may support assessment of cognitive changes associated with conditions such as traumatic brain injury, stroke, dementia, or epilepsy. It includes integrating patient data, interpreting standardized test results, clinical decision-making, treatment planning, and report preparation—not simply administering or scoring tests.
Report 96133 only with the primary first-hour service, 96132. Documentation should identify the evaluation activities and support the additional time billed, including interpretation, integration, decisions, planning, and reporting. Test administration and scoring may be represented by separate testing codes when those services are performed and meet reporting requirements. Under the CMS rule provided, this add-on is paid within the primary procedure’s global period.
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 96133 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$93.07 to $132.36
109 of 109 payment localities
96133 rates by state
Office rate range in each state. Select a state to see its payment localities.
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Local rates. Clear comparisons.
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$93.07
$132.36
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 | $132.36 | 1 |
| AL | $93.61 | 1 |
| AR | $93.07 | 1 |
| AZ | $96.78 | 1 |
| CA | $101.71–$118.78 | 29 |
| CO | $100.53 | 1 |
| CT | $101.76 | 1 |
| DC | $107.12 | 1 |
| DE | $97.74 | 1 |
| FL | $96.80–$100.19 | 3 |
| GA | $94.57–$98.70 | 2 |
| GU | $101.93 | 1 |
| HI | $101.93 | 1 |
| IA | $94.76 | 1 |
| ID | $94.97 | 1 |
| IL | $95.48–$99.70 | 4 |
| IN | $95.20 | 1 |
| KS | $94.49 | 1 |
| KY | $94.29 | 1 |
| LA | $94.19–$96.08 | 2 |
| MA | $100.46–$106.63 | 2 |
| MD | $98.85–$107.12 | 3 |
| ME | $95.07–$97.33 | 2 |
| MI | $95.19–$97.21 | 2 |
| MN | $98.31 | 1 |
| MO | $93.47–$96.34 | 3 |
| MS | $93.28 | 1 |
| MT | $97.86 | 1 |
| NC | $95.50 | 1 |
| ND | $97.47 | 1 |
| NE | $95.01 | 1 |
| NH | $99.08 | 1 |
| NJ | $103.47–$107.11 | 2 |
| NM | $95.37 | 1 |
| NV | $97.78 | 1 |
| NY | $96.08–$108.62 | 5 |
| OH | $95.11 | 1 |
| OK | $94.32 | 1 |
| OR | $97.54–$102.26 | 2 |
| PA | $95.23–$100.47 | 2 |
| PR | $98.20 | 1 |
| RI | $100.08 | 1 |
| SC | $95.35 | 1 |
| SD | $97.42 | 1 |
| TN | $94.67 | 1 |
| TX | $94.96–$99.76 | 8 |
| UT | $95.89 | 1 |
| VA | $97.13–$107.12 | 2 |
| VI | $98.20 | 1 |
| VT | $97.22 | 1 |
| WA | $100.24–$108.22 | 2 |
| WI | $96.07 | 1 |
| WV | $94.00 | 1 |
| WY | $97.69 | 1 |
How the 96133 rate is calculated
Each of 96133’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 · 96133
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.96Practice expense 0.95Malpractice 0.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 96133
The CMS indicators that decide how 96133 is paid alongside other services.
CMS payment indicators · 96133
Neuropsychological evaluation
| 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. |
96133 compared with similar codes
Compare codes
96133 vs 96132 vs 96131 vs 96137: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 96132Neuropsychological evaluation
- 96132 is the primary first-hour neuropsychological evaluation service; 96133 reports additional evaluation time and is not billed alone.
- 96131Psychological testing
- 96131 covers additional-hour psychological testing evaluation. 96133 is for neuropsychological testing evaluation.
- 96137Test administration
- 96137 reports additional physician or qualified professional time administering and scoring tests; 96133 reports additional evaluation, interpretation, and reporting work.
96133 billing questions
Can 96133 be reported by itself?
No. It is an add-on to 96132, the primary first-hour neuropsychological evaluation service.
How is 96133 different from 96137?
96133 covers additional evaluation work such as integrating findings and preparing a report. 96137 represents additional physician or qualified health care professional time administering and scoring tests.
What documentation supports an additional unit?
Document the evaluation work performed and the time supporting the additional service, such as interpretation of test results, integration of clinical data, decision-making, treatment planning, and reporting.
Does 96133 include test administration?
It represents evaluation and interpretation work, not test administration itself. When separately performed and reportable, administration and scoring may be represented with codes such as 96136–96139.
Which code is used for psychological rather than neuropsychological evaluation?
96131 is the additional-hour code for psychological testing evaluation. Use 96133 when the work is neuropsychological testing evaluation.
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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