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CMS RVU26D · Effective 2026-10-01

96137 Test administration Medicare reimbursement rates in Wisconsin

Reports each additional 30 minutes of psychological or neuropsychological test administration and scoring performed by a physician or qualified health care professional. Compare 96137 office and facility rates across CMS payment localities in Wisconsin.

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 96137 in Wisconsin?

Wisconsin has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.

Office / nonfacility

$36.16

1 of 1 localities have a supported rate.

Payment area: Wisconsin

One mapped payment locality.

Facility setting

$16.32

1 of 1 localities have a supported rate.

Payment area: Wisconsin

One mapped payment locality.

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.

Find 96137 in your payment locality →

Psychological testing

About 96137: Additional professional test administration and scoring

Reports each additional 30 minutes of psychological or neuropsychological test administration and scoring performed by a physician or qualified health care professional.

Code 96137 represents each additional 30 minutes of psychological or neuropsychological test administration and scoring by a physician or other qualified health care professional, after the initial 30 minutes. It fits standardized testing such as memory, attention, intellectual, or personality measures when a psychologist, neuropsychologist, or other eligible clinician personally administers and scores the tests. These services may occur in behavioral health, neurology, rehabilitation, or specialty assessment settings to evaluate concerns such as cognitive change, brain injury, or emotional functioning.

Report 96137 with 96136 for the same testing service; it is an add-on and is not reported by itself. CMS pays it within the primary procedure's global period. Documentation should identify the tests, the clinician who administered and scored them, and the time attributable to those tasks. Keep test administration and scoring time distinct from interpretation, integration, clinical decision-making, and reporting, which are evaluation services.

CMS billing rules for 96137

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 RVU0.46 · 41%
  • Practice expense (office) RVU0.65 · 59%
  • Malpractice RVU0.00 · 0%

347.5K

Medicare services in 2024 · #283 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.

96137 compared with similar codes

Office rates for Wisconsin, from the same CMS release.

96136

Test administration

Physician or QHP, first 30 minutes

$42.25

96136 covers the initial 30 minutes of physician or qualified health care professional test administration and scoring; 96137 covers each additional 30 minutes.

96139

Psychology testing

Technician, each additional 30 minutes

$33.92

96139 represents additional administration and scoring performed by a technician. Use 96137 when the physician or qualified health care professional performs those tasks.

96131

Psychological testing

Each additional hour

$85.41

96131 reports additional psychological test evaluation time, such as interpretation and reporting, rather than additional test administration and scoring.

96133

Neuropsychological evaluation

Each additional hour

$96.07

96133 reports additional neuropsychological test evaluation time, not additional administration and scoring time.

Compare 96137 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.

1 of 1 payment localities

Office and facility base rates · shared scale starting at $0

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 96137 in Wisconsin.

PPRRVU2026_Oct_nonQPP.csv

12,760

Code
96137
Physician work
0.46
Practice expense
0.65
Malpractice
0.00

GPCI2026.csv

111

Locality
Wisconsin
Physician work
1.000
Practice expense
0.958
Malpractice
0.308
Office / nonfacility calculation for 96137 in Wisconsin
ComponentRVULocality factorAdjusted
Physician work0.46× 1.0000.4600
Practice expense0.65× 0.9580.6227
Malpractice0.00× 0.3080.0000
Total RVUs1.0827
Conversion factor× 33.4009

Office / nonfacility rate, Wisconsin$36.16

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.461
Practice expense0.650.958
Malpractice00.308

(0.46 × 1 + 0.65 × 0.958 + 0 × 0.308) × $33.4009 = $36.16

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work0.461
Practice expense0.030.958
Malpractice00.308

(0.46 × 1 + 0.03 × 0.958 + 0 × 0.308) × $33.4009 = $16.32

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

96137 billing questions

What primary code must accompany 96137?

Report 96137 with 96136 for the same psychological or neuropsychological testing service. It is an add-on code, not a stand-alone service.

How does 96137 differ from 96136?

96136 represents the initial 30 minutes of physician or qualified health care professional test administration and scoring. 96137 represents each additional 30 minutes.

When should 96139 be used instead?

Use 96139 for additional test administration and scoring time performed by a technician. 96137 is for time performed by a physician or other qualified health care professional.

Can test interpretation and the report be included in 96137 time?

96137 captures administration and scoring time. Interpretation, integration of results, clinical decision-making, and reporting are evaluation services, represented by codes such as 96130 or 96132.

What documentation supports reporting 96137?

Document the tests administered and scored, the clinician performing those tasks, and the time attributable to them. The record should support that this is additional time beyond the initial service reported with 96136.

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.

RVUs for 96137PPRRVU2026_Oct_nonQPP.csv, line 12,760 (RVU26D)
Geographic factors for WisconsinGPCI2026.csv, line 111 (RVU26D)