The 96136 CPT code covers the first 30 minutes of psychological or neuropsychological test administration and scoring done by a psychologist or another qualified professional. It is usually billed with 96130, the first hour of the psychologist's evaluation of the results: interpretation, the report and feedback to the patient.
In 2026 Medicare pays USD 43.76 for 96136 and USD 123.92 for 96130 nationally at the non facility rate. A testing claim often carries both codes plus add-on units for the extra time.
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CMS lists 96136 as "Psycl/nrpsyc tst phy/qhp 1st". In full, that is psychological or neuropsychological test administration and scoring by a physician or qualified health care professional, first 30 minutes. The APA coding guide says to report 96136 for the first 30 minutes and the add-on 96137 for each additional 30 minutes.
Who gives the tests decides the code. When a technician gives and scores them, the claim uses 96138 and 96139 instead. A single automated test scored by the platform is 96146.
96136 CPT code at a glance
| 96136 | 96130 | |
|---|---|---|
| Pays for | Giving and scoring the tests | Evaluating the results |
| Done by | Psychologist or other qualified professional | Psychologist or other qualified professional |
| Time unit | First 30 minutes | First hour |
| Add-on code | 96137, each further 30 minutes | 96131, each further hour |
| 2026 Medicare, non facility | USD 43.76 | USD 123.92 |
| 2026 Medicare, facility | USD 21.38 | USD 99.53 |
| Medicare telehealth list | Yes | Yes |
The testing code family
| Code | What it covers | Time unit | 2026 Medicare, national non facility |
|---|---|---|---|
| 96130 | Psychological testing evaluation by the psychologist | First hour | USD 123.92 |
| 96131 | Add-on to 96130 | Each additional hour | USD 86.51 |
| 96132 | Neuropsychological testing evaluation | First hour | USD 122.25 |
| 96133 | Add-on to 96132 | Each additional hour | USD 97.86 |
| 96136 | Test administration and scoring by the psychologist | First 30 minutes | USD 43.76 |
| 96137 | Add-on to 96136 | Each additional 30 minutes | USD 37.07 |
| 96138 | Test administration and scoring by a technician | First 30 minutes | USD 37.74 |
| 96139 | Add-on to 96138 | Each additional 30 minutes | USD 35.40 |
Rates are from the CMS 2026 relative value file (conversion factor 33.4009) before locality adjustment. Your Medicare contractor's local amount is what pays. Medicaid and commercial plans set their own rates.
What is the 96130 CPT code?
96130 is the first hour of the psychologist's evaluation of psychological testing, and 96131 covers each additional hour. For neuropsychological testing the pair is 96132 and 96133. The APA guide lists the work these codes cover:
- Integration of patient data
- Interpretation of standardized test results and clinical data
- Clinical decision making
- Treatment planning and report
- Interactive feedback to the patient, family members or caregivers
Medicare pays USD 123.92 for 96130 at the non facility rate and USD 99.53 at the facility rate. The evaluation is always done by the professional, even when a technician gave the tests.
How do 96130 and 96136 work together?
They describe two parts of one testing service. 96136 to 96139 pay for giving and scoring the tests. 96130 to 96133 pay for making sense of the results. The APA guide says evaluation services "must always be billed with test administration services" and "may be billed on the same or different days".
Testing often runs across several visits. The CMS billing article A57481 says testing "typically" takes 4 to 8 hours including administration and scoring. When it is done over several days, "the time for all testing should be combined and reported on the last day of service". That rule covers testing time. The APA guide still lets the evaluation go on its own date. A57481 comes from one Medicare contractor, so check the article that covers your state.
How do you count units for 96136 and 96130?
Units follow the time in each code. For the 30 minute codes, another add-on unit needs "at least an additional 16 minutes" past each full 30, per the APA guide. For the hourly evaluation codes, the first add-on unit needs at least 31 more minutes after the first hour. A57481 also says "a minimum of 31 minutes must be provided to report any per hour code". So under 31 minutes of evaluation, 96130 cannot be billed.
Here is one testing case worked through, at the 2026 national non facility rates:
| Time spent | Codes and units | Medicare, national |
|---|---|---|
| Psychologist gives and scores tests, 50 min | 96136 x1 + 96137 x1 | USD 80.83 |
| Technician gives and scores tests, 3 h 10 min | 96138 x1 + 96139 x5 | USD 214.74 |
| Psychologist evaluation, report and feedback, 2 h 15 min | 96130 x1 + 96131 x1 | USD 210.43 |
| Total for the case | USD 506.00 |
The tech time is 3 hours 10 minutes: the first 30 minutes is 96138, then five full 30 minute blocks are five units of 96139. The last 10 minutes do not reach 16, so they add nothing.
Who can bill 96130 and 96136?
Physicians can bill testing. Under A57481, so can clinical psychologists, independent psychologists, nurse practitioners, clinical nurse specialists and physician assistants, within their scope and state license. To bill Medicare, the practitioner needs a Medicare provider number and a license in the state where the testing happens.
Technician time goes on 96138 and 96139. A57481 describes the technician as working "under the clinician's direct supervision". The evaluation codes stay with the professional.
Is psychological testing covered for telehealth?
For Medicare, yes. All eight codes from 96130 to 96139 are on the CY 2026 Medicare telehealth list with the status "Maintain". Our guide to place of service codes covers POS 02 and 10. Medicaid and commercial plans keep their own lists.
How do you document psychological testing?
A57481 sets two rules for the record. It "must document the reason the tests are being performed". Testing with "no impact on a patient's plan of care" is not medically necessary. A testing record that holds up shows:
- The referral question and the reason for testing.
- Each test selected and why it answers that question.
- Who gave and scored the tests, the professional or a technician, with the time for each.
- The dates of each testing session when the work ran over several days.
- The evaluation time and what it covered: interpretation, report and feedback.
- How the results change the diagnosis or the treatment plan.
- Any prior authorization the plan requires, checked before the first session.
Why do psychological testing claims get denied?
The usual errors are below. Check each row before the claim goes out:
| What went out | Fix |
|---|---|
| 96130 with no testing billed on this or an earlier date | Bill the testing time on 96136 to 96139 |
| 96130 for under 31 minutes of evaluation | Do not bill the evaluation code yet |
| 96137 or 96139 with no base code | Add-ons are never billed alone; add 96136 or 96138 |
| An add-on unit for less than 16 extra minutes | Remove the unit |
| 96131 for less than 31 extra minutes | Remove the unit |
| Technician time billed as 96136 | Bill 96138 and 96139 |
| 96146 with two or more electronic tests in a session | Bill the administration time on 96136 to 96139 |
| Testing time split across several dates of service | Combine it on the last day of testing, if your contractor follows A57481 |
| Neurobehavioral status exam billed as testing | Use 96116 and 96121 |
| No reason for testing in the record | Document the referral question and how results inform treatment |
| Testing for Alzheimer's disease after the diagnosis | Not covered under A57481 |
A57481 sends some related services to other codes:
- Developmental and behavioral screening: 96110, 96112, 96113 and 96127.
- Neurobehavioral status exam: 96116 and 96121.
- A single automated test with an automated result: 96146.
- Aphasia assessment 96105, cognitive performance testing 96125.
For claims that come back, see our guides to denial management and claim scrubbing.
Sources
- CMS Medicare Coverage Database, Billing and Coding: Psychological and Neuropsychological Testing (A57481)
- APA Services, Up to code: Testing code changes are here, updated January 2025
- CMS 2026 physician fee schedule relative value file, January release
- CMS CY 2026 Medicare telehealth services list
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A testing claim needs minutes from more than one person, sometimes across several days. mdhub drafts the session note for your clinician to review and sign. For the codes around testing, see our pages on 90791, 90792 and 96127. Start a free trial, or book a demo if you run a clinic with 10 or more clinicians.
96136 and 96130 CPT code FAQ
The first 30 minutes of psychological or neuropsychological test administration and scoring done by a psychologist or other qualified professional. Each further 30 minutes is billed with 96137.
Who gives the tests. 96136 is test administration and scoring by the psychologist. 96138 is the same work done by a technician. Both cover the first 30 minutes.
Yes. 96136 is a base code and can go out alone. Its add-on 96137 cannot. The evaluation codes 96130 to 96133 need test administration billed, on the same day or a different one.
96136 pays for giving and scoring the tests. 96130 pays for the first hour of evaluating the results: interpretation, the report and feedback.
Medicare pays USD 123.92 for 96130 and USD 43.76 for 96136 nationally at the non facility rate. Facility rates are USD 99.53 and USD 21.38. Local rates vary.
One unit for each additional 30 minutes after the first 30 of 96136. A unit counts once at least 16 minutes of the next 30 are done.
Codes 96130 to 96139 are on the CY 2026 Medicare telehealth list. Medicaid and commercial plans set their own rules.
For Medicare, usually because the record does not show medical necessity. Under A57481, Medicare does not cover testing with no impact on the plan of care. Testing for Alzheimer's disease after the diagnosis is also excluded. Medicaid and commercial plans set their own rules.
