96132 with Medicare (national): what the policy says
1 row: Medicare. Public policy, not the member's benefits.
Medicare (national)
Original Medicare Part B, Physician Fee Schedule and Benefit Policy Manual · All states
| 96116 | Listed (neurobehavioral status exam, first hour (active on the 2026 PFS)) [1] |
|---|---|
| 96121 | Listed (add-on, each additional hour (active on the 2026 PFS)) [1] |
| 96130 | Listed (psychological testing evaluation, first hour (active on the 2026 PFS)) [1] |
| 96131 | Listed (add-on, each additional hour (active on the 2026 PFS)) [1] |
| 96132 | Listed (neuropsychological testing evaluation, first hour (active on the 2026 PFS)) [1] |
| 96133 | Listed (add-on, each additional hour (active on the 2026 PFS)) [1] |
| 96136 | Listed (test administration and scoring by the clinician, first 30 minutes (active on the 2026 PFS)) [1] |
| 96137 | Listed (add-on, each additional 30 minutes (active on the 2026 PFS)) [1] |
| 96138 | Listed (test administration and scoring by a technician, first 30 minutes (active on the 2026 PFS)) [1] |
| 96139 | Listed (add-on, technician, each additional 30 minutes (active on the 2026 PFS)) [1] |
| 96146 | Listed (single automated instrument, automated result only (active on the 2026 PFS)) [1] |
| Where it applies | Testing is paid as a diagnostic test under section 1861(s)(3) of the Social Security Act. Incident to billing is not authorized for these tests. Diagnostic testing is outside the outpatient mental health treatment limitation. [2] |
| Telehealth rules | Codes 96116, 96121, 96125, 96130 to 96133 and 96136 to 96139 are on the CY 2026 final list of Medicare telehealth services. We did not find 96146 on that list. Through December 31, 2027, patients can receive Medicare telehealth services anywhere in the United States and territories. [3][4] |
| Who can bill | Clinical psychologists, independently practicing psychologists (with a physician order), NPs, CNSs and PAs within state scope, and physicians. A psychologist on an institution's staff does not bill; the institution does. An independent psychologist who is not a clinical psychologist must put the ordering physician's name and address on the claim. [2] |
| Payment | 2026 national payment computed from the published RVUs times the $33.4009 conversion factor (non-QPP file), non-facility rate: 96130 $123.92, 96131 $86.51, 96132 $122.25, 96133 $97.86, 96136 $43.76, 96137 $37.07, 96138 $37.74, 96139 $35.40, 96146 $2.34. Facility rates for 96130, 96132 and 96136 are $99.53, $98.53 and $21.38. Local rates vary by GPCI. [1] |
| Also | The manual says there is no payment under the fee schedule for services performed by students or trainees. A trainee being present while a licensed clinician tests does not stop the clinician from billing. The manual text still names the pre 2019 code numbers. [2] |
- CMS: CY 2026 Physician Fee Schedule relative value file RVU26D (PPRRVU2026_Oct_nonQPP.csv, conversion factor 33.4009), checked October 30, 2026
- CMS: Medicare Benefit Policy Manual (100-02) Chapter 15, section 80.2 Psychological Tests and Neuropsychological Tests, checked October 30, 2026
- CMS: List of Telehealth Services, CY 2026 PFS final list, checked October 30, 2026
- CMS: Telehealth FAQ (updated 10/8/26), checked October 30, 2026
What Medicare (national)'s policy says about 96132
96132 is the CPT code for neuropsychological testing evaluation services, first hour. At Medicare (national) it is listed: named in the payer's public policy. Each line below is from the cited text:
- Where it is listed. Active on the 2026 physician fee schedule (status A). Neuropsychological testing evaluation services, first hour. (CMS, checked October 30, 2026)
- Telehealth. On the CY 2026 final list of Medicare telehealth services (action: Maintain). (CMS, checked October 30, 2026)
- Payment. 2026 national payment computed from RVUs times the $33.4009 conversion factor: $122.25 non-facility (3.66 RVUs), $98.53 facility (2.95 RVUs). Work RVU 2.56. (CMS, checked October 30, 2026)
96132 at other payers
- 96132 with Nevada Medicaid: limited.
The rest of Medicare (national)'s psychological testing rules
The Medicare (national) row has its codes, telehealth rule, limits and authorization, each with its source. Other codes we checked at Medicare (national): 96130, 96136, 96138 and 96146. Before the claim goes out, compare it with the row in the table above.