How much does Medicare pay for CPT 96137?

Medicare allowed an average of $35.38 per service and paid $27.90 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $123.30, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 96137?

Administration of psychological or neuropsychological test, each additional 30 minutes. It was billed 307,150 times to 79,897 Medicare beneficiaries by 1,496 providers in 2024.

Does 96137 pay differently in an office than a hospital?

Yes. The allowed amount averaged $36.91 in an office setting and $17.70 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 96137 most?

Psychologist, Clinical, with 295,206 services from 1,346 clinicians. Next are Neurology, Internal Medicine, Psychiatry.

CPT 96137

Administration of psychological or neuropsychological test, each additional 30 minutes

$35.38Medicare-allowed amount per service, averaged across 307,150 services

Providers submitted

$123.30

Asking price, not received

Medicare allowed

$35.38

The fee schedule figure

Medicare paid

$27.90

Balance is patient coinsurance

Providers submitted an average of $123.30 for this code and Medicare allowed $35.38 — 3.5× 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 $27.90 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $36.91
Hospital / facility: $17.70

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. 282,778 services were billed in an office setting and 24,372 in a facility.

Services: 307,150
Beneficiaries: 79,897
Providers billing it: 1,496
Total allowed: $10,866,967

What Medicare pays for CPT 96137

Across 307,150 services billed by 1,496 providers to 79,897 beneficiaries, Medicare allowed an average of $35.38 per service. That is 3.8 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 96137

Specialty	Services	Beneficiaries	Avg allowed	Providers
Psychologist, Clinical	295,206	72,314	$35.33	1,346
Neurology	5,376	3,848	$39.26	65
Internal Medicine	1,355	1,204	$37.03	31
Psychiatry	938	250	$32.82	8
Family Practice	919	650	$41.14	6
Nurse Practitioner	874	670	$26.99	21
Neuropsychiatry	770	185	$27.91	5
Pain Management	633	153	$37.02	2
General Practice	246	136	$44.97	2
Physical Medicine and Rehabilitation	224	141	$35.76	2
Cardiology	187	171	$34.23	1
Neurosurgery	127	28	$41.45	1
Licensed Professional Counselor	127	17	$23.41	1
Interventional Pain Management	59	32	$36.86	1
Hospitalist	51	44	$41.28	1

96137 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
Florida	42,814	$36.17	$28.95	138
California	39,462	$37.29	$26.33	194
Texas	32,617	$34.29	$28.13	117
New York	20,450	$39.62	$28.06	109
Illinois	18,360	$33.38	$26.11	73
Massachusetts	15,803	$35.91	$26.86	66
New Jersey	10,749	$39.79	$28.43	58
Pennsylvania	10,602	$36.07	$28.13	52
Tennessee	7,255	$32.22	$27.29	32
Colorado	7,163	$37.23	$29.01	38
Maryland	6,176	$39.82	$27.84	27
North Carolina	5,684	$32.71	$27.09	44
Michigan	5,683	$27.21	$22.01	52
Connecticut	5,481	$36.54	$27.64	37
Georgia	5,362	$35.15	$28.57	28
Arizona	5,032	$36.05	$29.12	26
Oregon	4,936	$37.13	$28.23	21
Virginia	4,878	$31.03	$24.24	30
Ohio	4,703	$32.13	$25.84	35
South Carolina	4,632	$32.89	$27.74	16
Washington	4,607	$34.44	$25.87	23
Arkansas	3,683	$32.13	$28.04	12
Nevada	3,249	$36.15	$28.81	20
Rhode Island	2,842	$34.91	$27.10	18
New Hampshire	2,826	$33.64	$25.99	10
Kentucky	2,799	$32.78	$27.81	16
Missouri	2,490	$31.28	$28.23	17
Oklahoma	2,479	$29.77	$25.30	13
Wisconsin	2,408	$26.52	$22.61	13
Indiana	2,300	$33.37	$28.18	24
Iowa	2,275	$28.74	$23.88	17
Utah	2,232	$33.64	$28.60	10
Minnesota	2,105	$34.12	$27.06	20
Alabama	1,970	$33.37	$28.05	6
Kansas	1,714	$34.68	$29.33	9
New Mexico	1,572	$33.32	$26.56	8
Idaho	1,199	$34.69	$29.41	7
Nebraska	786	$34.89	$29.15	7
Delaware	753	$36.23	$29.39	3
District of Columbia	751	$41.98	$29.51	5
Mississippi	709	$33.15	$29.35	8
Louisiana	578	$33.89	$29.27	6
South Dakota	531	$30.61	$24.73	7
Vermont	515	$36.62	$29.42	4
North Dakota	475	$17.35	$14.06	3
Alaska	376	$47.02	$29.45	3
Puerto Rico	325	$36.72	$29.39	2
Hawaii	270	$39.94	$29.44	4
Maine	174	$36.13	$27.08	2
Montana	162	$25.60	$20.18	3
West Virginia	154	$34.03	$29.18	3

Related codes

96127Assessment of emotional or behavioral problems$4.47
96133Evaluation of neuropsychological test$92.52
96139Administration of psychological or neuropsychological test by technici$34.56
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.