$91.83–$94.51
96116 reports the initial hour of the neurobehavioral status examination. Use 96121 only for additional time and only with 96116.
On this page
CMS RVU26D · Effective 2026-10-01
96121 Neurobehavioral exam Medicare reimbursement rates in Michigan
Reports additional physician or qualified health care professional time assessing cognitive and behavioral functioning beyond the initial neurobehavioral status examination. Compare 96121 office and facility rates across CMS payment localities in Michigan.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 96121 in Michigan?
Michigan has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$73.96–$75.08
2 of 2 localities have a supported rate.
Facility setting
$61.15–$61.55
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Neurobehavioral assessment
About 96121: Additional-hour neurobehavioral status examination
Reports additional physician or qualified health care professional time assessing cognitive and behavioral functioning beyond the initial neurobehavioral status examination.
This add-on reports additional professional time spent evaluating cognitive and behavioral functioning, such as attention, memory, language, reasoning, judgment, planning, and problem solving. A physician or other qualified health care professional may perform the assessment in an office, hospital, or other appropriate setting when a patient has concerns such as cognitive changes after a brain injury, stroke, or suspected dementia. The service can include clinical assessment, review and interpretation of relevant findings, and preparation of the report.
Report 96121 only with 96116, the initial-hour neurobehavioral status examination. Documentation should identify the clinical concern, assessment performed, findings, and the time supporting the additional hour. This is an add-on code: CMS pays it only when reported with its primary procedure, and its payment falls within that procedure’s global period. Do not report it as a stand-alone service.
CMS billing rules for 96121
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU1.71 · 76%
- Practice expense (office) RVU0.54 · 24%
- Malpractice RVU0.01 · 0%
32.2K
Medicare services in 2024 · #945 by national volume
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.
96121 compared with similar codes
Office rates for Michigan, from the same CMS release.
$119.56–$122.65
96132 is the initial-hour code for neuropsychological testing evaluation. Choose it for that evaluation service, not additional time on a 96116 neurobehavioral status examination.
$99.15–$102.22
96125 describes cognitive performance testing by a health care professional. It is not the additional-hour code for the clinical neurobehavioral assessment reported with 96116.
Compare 96121 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Detroit →
Office / nonfacility
$75.08
Facility
$61.55
Rest Of Michigan →
Office / nonfacility
$73.96
Facility
$61.15
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96121 billing questions
What must be reported with 96121?
Report 96121 with 96116, which covers the initial hour of the neurobehavioral status examination. CMS treats 96121 as an add-on and pays it within the primary procedure’s global period.
How is 96121 different from 96116?
96116 reports the initial-hour service; 96121 reports additional time for that same neurobehavioral assessment. Do not use 96121 by itself.
How is this different from neuropsychological testing evaluation?
96121 extends a clinical neurobehavioral status examination. Codes 96132 and 96133 are for neuropsychological testing evaluation, a distinct service; select based on the work actually performed and documented.
What documentation supports an additional unit?
Document the assessment activities, relevant findings, and time attributable to the additional service. The record should make clear that the work extends the 96116 examination rather than describing a separate service.
Can 96121 be billed for testing administration?
96121 reports additional neurobehavioral assessment time, not test administration and scoring by themselves. For psychological or neuropsychological test administration and scoring, consider the applicable testing codes when that work was 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
12,74996112,,Devel tst phys/qhp 1st hr,A,,2.56,1.05,,0.50,,0.14,3.75,3.20,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,04,0,99,0.00,0.00,0.00
12,75096113,,Devel tst phys/qhp ea addl,A,,1.16,0.49,,0.16,,0.03,1.68,1.35,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,04,0,99,0.00,0.00,0.00
12,75196116,,Nubhvl xm phys/qhp 1st hr,A,,1.86,0.90,,0.24,,0.06,2.82,2.16,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,04,0,99,0.00,0.00,0.00
12,75296121,,Nubhvl xm phy/qhp ea addl hr,A,,1.71,0.54,,0.12,,0.01,2.26,1.84,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,04,0,99,0.00,0.00,0.00
12,75396125,,Cognitive test by hc pro,A,,1.70,1.34,,1.34,NA,0.04,3.08,3.08,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,75496127,,Brief emotional/behav assmt,A,,0.00,0.14,,0.14,NA,0.01,0.15,0.15,3,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,75596130,,Psycl tst eval phys/qhp 1st,A,,2.56,1.06,,0.33,,0.09,3.71,2.98,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,04,0,99,0.00,0.00,0.00