Billing code 96138: Psychological testingMedicare rate & RVUs

Medicare pays $37.74 for 96138 nationally in the office. Local office rates run $32.31–$54.12.

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

What 96138 covers

A psychometrist or other trained testing technician administers and scores standardized instruments that assess psychological or neuropsychological functions, such as memory, attention, or emotional and behavioral functioning. Typical referrals include cognitive concerns after neurologic illness, suspected learning or attention problems, and diagnostic clarification of mood or behavior symptoms. The technician performs the testing under the direction of a physician or other qualified health professional in an office or facility.

Report 96138 for the initial 30 minutes of technician time spent administering and scoring at least two tests. Use 96139 for additional technician time in 30-minute increments. Documentation should identify the tests, technician, time, results, and supervising professional, and support the clinical reason for testing. When a qualified health professional performs the test administration and scoring, consider 96136 instead. CMS assigns no physician-work RVU to 96138; its relative values include practice expense and malpractice components.

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 96138 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

96138 rates by state

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

How the 96138 rate is calculated

Each of 96138’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 96138

96138 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.

96138 compared with similar codes

How to choose

96136Test administration

Both cover test administration and scoring, but 96138 is for technician-performed work and 96136 is for work performed by a physician or other qualified health professional.

96139Psychology testing

96138 reports the initial 30 minutes of technician testing; 96139 reports additional technician time in 30-minute increments.

96130Psychological evaluation

96138 covers technician administration and scoring. 96130 covers the qualified health professional's psychological test evaluation and report.

96146Automated testing

96146 describes a single automated test with an automated result; 96138 is for technician administration and scoring of at least two tests.

Codes related to 96138

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