How much does Medicare pay for CPT 96133?

Medicare allowed an average of $92.52 per service and paid $73.05 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $282.88, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 96133?

Evaluation of neuropsychological test, each additional hour. It was billed 385,407 times to 128,682 Medicare beneficiaries by 2,155 providers in 2024.

Does 96133 pay differently in an office than a hospital?

Yes. The allowed amount averaged $95.35 in an office setting and $75.03 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 96133 most?

Psychologist, Clinical, with 371,684 services from 2,060 clinicians. Next are Neurology, Neuropsychiatry, Psychiatry.

CPT 96133

Evaluation of neuropsychological test, each additional hour

$92.52Medicare-allowed amount per service, averaged across 385,407 services

Providers submitted

$282.88

Asking price, not received

Medicare allowed

$92.52

The fee schedule figure

Medicare paid

$73.05

Balance is patient coinsurance

Providers submitted an average of $282.88 for this code and Medicare allowed $92.52 — 3.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $73.05 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $95.35
Hospital / facility: $75.03

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 331,803 services were billed in an office setting and 53,604 in a facility.

Services: 385,407
Beneficiaries: 128,682
Providers billing it: 2,155
Total allowed: $35,657,856

What Medicare pays for CPT 96133

Across 385,407 services billed by 2,155 providers to 128,682 beneficiaries, Medicare allowed an average of $92.52 per service. That is 3.0 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 96133

Specialty	Services	Beneficiaries	Avg allowed	Providers
Psychologist, Clinical	371,684	123,672	$92.57	2,060
Neurology	7,440	2,640	$91.72	48
Neuropsychiatry	1,615	623	$87.42	10
Psychiatry	1,283	460	$87.52	15
Nurse Practitioner	978	594	$77.28	9
Family Practice	689	273	$95.85	3
Unknown Supplier/Provider Specialty	589	78	$102.49	1
Internal Medicine	526	122	$96.97	4
General Practice	402	150	$110.58	2
Neurosurgery	102	28	$103.01	1
Physical Medicine and Rehabilitation	99	42	$85.01	2

96133 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	53,358	$95.65	$71.63	203
Florida	42,244	$94.73	$75.07	187
Texas	35,274	$89.96	$71.65	163
Illinois	21,798	$91.96	$71.34	120
Massachusetts	19,500	$93.98	$71.13	98
New York	16,797	$101.78	$74.14	106
Arizona	15,808	$91.69	$74.58	63
Pennsylvania	14,752	$92.06	$71.75	96
Virginia	12,022	$92.62	$71.27	52
Michigan	10,867	$87.93	$70.09	87
North Carolina	10,834	$88.94	$73.10	62
Ohio	9,698	$87.77	$69.01	73
New Jersey	8,750	$101.98	$75.12	60
Maryland	6,378	$100.34	$73.15	35
Georgia	6,369	$91.21	$72.76	40
Colorado	6,326	$94.43	$73.90	44
Tennessee	6,193	$86.21	$69.89	28
Arkansas	6,024	$79.61	$67.33	19
Wisconsin	5,608	$83.97	$67.64	60
Washington	5,385	$93.00	$70.87	42
Nevada	5,263	$93.88	$74.76	22
Connecticut	4,769	$95.56	$71.65	43
Oregon	4,662	$95.96	$74.70	28
Indiana	4,588	$88.10	$71.37	41
South Carolina	4,352	$90.69	$74.25	17
Minnesota	4,329	$89.04	$69.31	54
Kansas	4,051	$87.70	$73.07	18
Oklahoma	3,627	$89.00	$73.34	14
Missouri	3,617	$89.08	$71.59	32
Iowa	3,446	$79.36	$63.69	25
New Hampshire	3,022	$91.09	$70.86	18
Rhode Island	2,874	$93.69	$71.65	20
North Dakota	2,596	$78.82	$62.77	13
Utah	2,146	$87.54	$71.12	14
Kentucky	2,143	$89.88	$73.56	22
Nebraska	2,005	$89.77	$74.92	10
New Mexico	1,852	$92.63	$73.96	14
Alabama	1,698	$88.72	$74.22	15
South Dakota	1,374	$82.77	$66.93	11
Idaho	1,120	$87.09	$71.17	6
Louisiana	961	$80.84	$64.15	13
West Virginia	884	$81.58	$63.28	11
Alaska	860	$130.07	$75.66	6
Montana	856	$86.87	$67.13	8
District of Columbia	719	$105.34	$74.38	6
Vermont	706	$94.29	$75.71	7
Hawaii	691	$97.63	$75.16	6
Mississippi	622	$90.50	$76.46	7
Delaware	600	$93.32	$75.39	3
Wyoming	357	$93.58	$75.04	3
Maine	356	$85.85	$70.07	6
Puerto Rico	212	$94.84	$75.04	3
ZZ	64	$72.72	$52.56	1

Related codes

96127Assessment of emotional or behavioral problems$4.47
96139Administration of psychological or neuropsychological test by technici$34.56
96137Administration of psychological or neuropsychological test$35.38
96132Evaluation of neuropsychological test$121.64
96160Administration and interpretation of patient-focused health risk asses$2.79
96138Administration of psychological or neuropsychological test by technici$33.17
96136Administration of psychological or neuropsychological test$38.12
96116Exam of neurobehavioral status$88.32
96130Evaluation of psychological test$112.99
96131Evaluation of psychological test$82.62
96165Treatment of behavior impacting health in group setting$4.02
96121Exam of neurobehavioral status$71.55

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.