Billing code 96105: Aphasia assessmentMedicare rate & RVUs in Delaware
Report 96105 for an hourly assessment of language impairment consistent with aphasia, including interpretation and a written report.
Medicare pays $96.88 for 96105 in the office in Delaware (Delaware). Which amount applies depends on the service address.
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 9 sections
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.
96105 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | $96.88 | Unavailable |
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.
How the rate is built · 96105
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.75Practice expense 1.11Malpractice 0.05
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
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.
Place of service · 96105
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
Non-facility (office) rate · national
$97.20
Only one setting is priced for this code.
96105 compared with similar codes
Compare codes
96105 vs 96125 vs 96116 vs 92523: national Medicare rates
Swap in your local Medicare rate.
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.
96105 billing questions
When should I report 96105 instead of cognitive testing?
Use 96105 when the service assesses language impairment associated with aphasia. Cognitive testing under 96125 addresses cognitive abilities rather than an aphasia-focused language assessment.
Is interpretation and the report separately billable under 96105?
Interpretation and the report are included in the hourly aphasia assessment. They do not constitute separate 96105 services.
How should the assessment time be documented?
Record the time attributable to the aphasia assessment and describe the language functions evaluated, methods used, findings, and interpretation. Report the service on an hourly basis.
Can 96105 be reported for a general speech-language evaluation?
Use 96105 when the service is specifically an assessment of aphasia. A broader speech-language evaluation, such as one evaluating speech sound production and language comprehension or expression, may fit a different code.
Who typically performs the assessment?
A speech-language pathologist commonly performs an aphasia assessment, including for patients with communication changes following stroke or brain injury.
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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