Billing code 96127: Behavioral screening toolMedicare rate & RVUs in Alaska

Administration and scoring of a brief standardized emotional or behavioral questionnaire, such as the PHQ-9 or GAD-7, reported per instrument administered and scored.

CMS RVU26DEffective Oct 1, 20261 payment locality956K Medicare services in 2024

Medicare pays $5.16 for 96127 in the office in Alaska (Alaska*). Which amount applies depends on the service address.

$5.16Office (non-facility)
—Hospital or facility

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 96127 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Alaska
  2. What 96127 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 96127 covers

This service involves a brief standardized questionnaire used to screen for or monitor emotional and behavioral symptoms. Typical tools include the PHQ-9 or PHQ-A for depression, the GAD-7 for anxiety, Vanderbilt rating scales for ADHD, and the Pediatric Symptom Checklist. A patient, parent, or teacher may complete the form, and clinical staff commonly score it. It is used in primary care, pediatrics, and behavioral health practices during well visits, problem visits, and medication follow-ups, typically in an office setting.

Report one unit for each instrument administered, scored, and documented; a PHQ-9 and GAD-7 completed at one visit support two units. A repeat administration needs its own scored result and clinical purpose. The record should identify the instrument, its score, and any clinical response. CMS classifies 96127 as a technical-component-only code with no physician work value. It covers administration and scoring; separate coding covers interpretation when the requirements for that service are met. Do not append modifier 26 or TC to 96127.

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.

96127 in Alaska*

96127 office and facility rates by payment locality
Payment localityOfficeFacility
Alaska*$5.16Unavailable

How the 96127 rate is calculated

Each of 96127’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 · 96127

RVUs × geographic indexes × conversion factor

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.14

0.14 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

0.1500

Conversion factor

$33.4009

Medicare rate

$5.01

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 96127

The CMS indicators that decide how 96127 is paid alongside other services.

CMS payment indicators · 96127

Behavioral screening tool

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
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/technical3Technical component only.

96127 compared with similar codes

Compare codes · National

5 codes, side by side

  • 96127

    Behavioral screening tool0 wRVU

    $5.01

  • 96110

    Not on the physician fee schedule0 wRVU

    Not priced

  • 96146

    Automated testing0 wRVU

    $2.34−$2.67

  • 96138

    Psychological testing0 wRVU

    $37.74+$32.73

  • 96161

    Health risk assessment0 wRVU

    $3.34−$1.67

How to choose

96110Developmental screen w/score
Use 96110 for a developmental screening tool such as the ASQ. Use 96127 for an instrument assessing the patient's mood, anxiety, attention, or behavioral symptoms.
96146Automated testing
96146 covers a single psychological or neuropsychological test administered electronically with an automated result. 96127 covers a brief scored emotional or behavioral assessment.
96138Psychological testing
96138 covers the first 30 minutes of technician-administered and scored psychological or neuropsychological testing involving two or more tests. Report 96127 per brief standardized emotional or behavioral instrument, not by time.
96161Health risk assessment
96161 applies when the caregiver's own risk is assessed for the patient's benefit. 96127 applies when the instrument assesses the patient's own emotional or behavioral status.

96127 billing questions

How many units are reported when several screening tools are used at one visit?

Report one unit for each standardized instrument administered and scored. A repeat use of the same instrument needs a separate administration, scored result, and clinical purpose; rescoring one completed form does not support another unit.

Is the provider's review of the score billed separately?

96127 covers administration and scoring, not professional interpretation. CMS identifies separate coding for interpretation; routine use of the result during a visit does not, by itself, establish a separately reportable interpretation service.

Should maternal depression screening at an infant's well-child visit use this code?

Screening the parent for the child's benefit, for example with the Edinburgh Postnatal Depression Scale, is generally reported with caregiver-focused code 96161 rather than 96127.

What documentation supports each unit?

Identify the instrument, record who completed it and its score, and retain the scored form or result. Document the clinical response when indicated, such as a referral, medication change, or follow-up plan.

Can this be reported with a developmental screen at the same visit?

Yes, when separate instruments are administered and scored. A developmental tool such as the ASQ is reported with 96110, while a distinct emotional or behavioral tool is reported with 96127.

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 96127PPRRVU2026_Oct_nonQPP.csv, line 12,754 (RVU26D)
Geographic factors for Alaska*GPCI2026.csv, line 5 (RVU26D)

Open CMS sourceHow we calculate rates

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