CPT Code 96137 Billing Guide

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• 96137

CPT Code 96137 Billing Guide

CPT 96137 add-on code for psychological or neuropsychological test administration and scoring, each additional 30 minutes.

Quick Reference

Code

96137

Code System

CPT

Category

CPT Codes

Published

Jan 25, 2024

Updated

Mar 2, 2026

Reading Time

20 min

CPT® is a registered trademark of the American Medical Association. All CPT code descriptions on this page are paraphrased in original wording; consult the current CPT® codebook published by the AMA for authoritative descriptors.

Understanding CPT Code 96137: Psychological/Neuropsychological Test Administration and Scoring by Qualified Professional, Each Additional 30 Minutes

Comprehensive psychological and neuropsychological evaluations frequently require extended testing sessions that go well beyond the initial 30-minute window captured by CPT code 96136. When the qualified professional — the psychologist, psychiatrist, or other credentialed clinician — personally administers and scores standardized tests for longer durations, each additional 30-minute increment beyond the first is captured by CPT code 96137. This add-on code is a critical component of accurate billing for extended testing sessions, and its correct usage directly affects both reimbursement and compliance.

Introduction

The American Psychological Association estimates that comprehensive neuropsychological evaluations, which include extensive test batteries administered over multiple hours, are essential for diagnosing complex cognitive and behavioral conditions, particularly in populations with co-occurring substance use and mental health disorders. ↗ These evaluations routinely exceed the 30-minute threshold covered by the base administration code, making add-on billing through 96137 a standard part of the testing billing process.

The 2019 restructuring of psychological and neuropsychological testing CPT codes established a clear paired structure for test administration by the qualified professional: 96136 for the first 30 minutes and 96137 for each additional 30-minute increment. This pairing mirrors the technician administration pair of 96138 (first 30 minutes) and 96139 (each additional 30 minutes). Understanding how these add-on codes work — and the specific time-tracking and documentation requirements they carry — is essential for any practice that delivers extended psychological testing services.

In behavioral health settings, the relevance of 96137 is heightened by the complexity of the patient populations served. Patients presenting with substance use disorders, co-occurring psychiatric conditions, traumatic brain injuries, or cognitive decline from chronic substance use often require extensive test batteries. A comprehensive neuropsychological evaluation may involve three, four, or more hours of direct test administration, generating multiple units of 96137 in addition to the base 96136 code. Incorrect time tracking, inappropriate unit calculation, or failure to properly document the extended administration time are common billing errors that expose practices to audit risk and revenue loss.

This guide provides psychologists, neuropsychologists, psychiatrists, behavioral health administrators, and medical billers with detailed guidance on billing 96137 correctly. It covers the code definition, time-tracking requirements, documentation standards, reimbursement considerations, compliance obligations, and the practical challenges of billing for extended professional-administered testing sessions.

For practices using behavioral health management software, accurate tracking of face-to-face testing time is essential for compliant 96137 billing. ’s treatment planning tools can support the documentation workflows that underpin correct billing for extended testing services.

96137 Overview

CPT code 96137 is defined as: “Psychological or neuropsychological testing administration and scoring by physician or other qualified health care professional, two or more tests, any method, each additional 30 minutes (List separately in addition to code for primary procedure).”

Purpose and Significance

The purpose of 96137 is to capture each additional 30-minute increment of face-to-face test administration and scoring by the qualified professional beyond the first 30 minutes covered by 96136. It is classified as an add-on code (indicated by the ”+” symbol in the CPT manual and the instruction to “list separately in addition to code for primary procedure”), meaning it can never be reported as a standalone service.

The significance of 96137 in the testing code structure is straightforward: comprehensive testing evaluations almost always require more than 30 minutes of administration time. Without 96137, providers would be unable to bill for the additional professional time invested in extended test batteries. The code ensures that the full scope of professional-administered testing is captured and reimbursed appropriately.

The clinical context for 96137 includes:

• Neuropsychological test batteries that typically require 2-4 hours of direct administration (e.g., Halstead-Reitan Battery, comprehensive batteries including WAIS-IV, WMS-IV, WCST, and multiple supplemental measures)
• Comprehensive psychological evaluations involving multiple personality, cognitive, and symptom-specific instruments
• Forensic evaluations that require extended testing to address complex medicolegal questions
• Behavioral health assessments for patients with co-occurring substance use and cognitive disorders, where extensive testing is needed to differentiate between substance-related cognitive deficits and independent neurological conditions

Quick Facts

The complete test administration code family by the qualified professional:

And the parallel technician codes:

Key requirement: 96137 must always be paired with 96136. It cannot be billed with 96138 or 96139 as those are technician administration codes. The add-on code must match the base code for the same provider type.

• Code Type: CPT Category I (Add-on Code)
• Service Category: Psychological/Neuropsychological Test Administration and Scoring
• Billing Unit: Each additional 30 minutes of face-to-face time beyond the first 30 minutes
• Coverage: Medicare, Medicaid (varies by state), most commercial payers
• Effective Date: January 1, 2019 (introduced as part of the testing code restructuring)

• 96136 — Test administration and scoring by qualified professional, first 30 minutes (base code)
• 96137 — Test administration and scoring by qualified professional, each additional 30 minutes (add-on to 96136)

• 96138 — Test administration and scoring by technician, first 30 minutes (base code)
• 96139 — Test administration and scoring by technician, each additional 30 minutes (add-on to 96138)

Detailed Breakdown

Components and Requirements

To bill 96137 correctly, the following requirements must be met:

Add-on to 96136 only: 96137 is an add-on code that can only be reported in conjunction with 96136. This means the qualified professional must have met all the requirements for 96136 (personal administration, two or more tests, first 30 minutes of face-to-face time) before any additional time can be captured under 96137. If the base code requirements are not met, no units of 96137 can be billed.

Time-based billing with 30-minute increments: Each unit of 96137 represents an additional 30 minutes of face-to-face test administration and scoring by the qualified professional. Time must be tracked and documented precisely. The standard time-rounding rules generally applied by CMS and most payers require that a minimum of 16 minutes beyond the prior threshold be spent to qualify for the next unit. For example, if the professional spends a total of 75 minutes on test administration, the billing would be 96136 x 1 (first 30 minutes) and 96137 x 1 (the additional 45 minutes, which exceeds the 16-minute threshold for the second 30-minute increment). If total time were 42 minutes, only 96136 x 1 would be billed because the additional 12 minutes does not meet the 16-minute midpoint threshold for a second unit.

Continued face-to-face administration by the same qualified professional: The face-to-face requirement continues for each 96137 unit. The same qualified professional who initiated the testing under 96136 must continue the administration. If a different professional takes over test administration mid-session, the time allocation and billing become more complex and should be carefully documented.

Maintained two-or-more-test requirement: The two-or-more-test requirement from 96136 carries through the entire administration session. However, the additional tests do not need to be different from those already counted under 96136 — the requirement is that the overall session involves two or more standardized tests, and the extended time under 96137 represents continued administration and scoring of those (or additional) tests.

Scoring time inclusion: As with 96136, the time spent by the qualified professional on scoring test protocols is included in the time calculation for 96137. If the professional scores tests during the session (between test administrations, during breaks, or immediately after the patient completes a test), that scoring time contributes to the total administration and scoring time captured by 96136 and 96137.

Behavioral observations during extended testing: Extended testing sessions provide particularly rich opportunities for behavioral observation. Over a multi-hour testing session, the qualified professional can observe changes in the patient’s attention, fatigue, effort, emotional regulation, and task approach that are clinically significant. These sustained observations are a key clinical benefit of professional-administered testing and should be documented comprehensively.

Common Pitfalls

• Billing 96137 without the base code 96136: This is the most fundamental error. As an add-on code, 96137 requires 96136 on the same claim for the same date of service by the same provider. Claims submitted with 96137 but without 96136 will be denied. Billing systems should have edit checks in place to prevent this error.
• Inaccurate time tracking and unit calculation: The most common practical challenge with 96137 is accurately tracking face-to-face time across extended testing sessions. Sessions may include breaks, patient rest periods, transitions between tests, and other interruptions that are not face-to-face administration time. Providers must track actual face-to-face administration and scoring time (not total session duration) and calculate 96137 units based on that net time minus the initial 30 minutes assigned to 96136.
• Billing 96137 for technician-administered additional time: If the qualified professional administered the first 30 minutes but a technician continued the remaining administration, the additional time should be billed under 96139 (add-on to 96138 ), not 96137. The provider type must be consistent within each base-plus-add-on pairing. However, a single date of service can include both professional-administered time (96136/96137) and technician-administered time ( 96138 / 96139 ) if both provider types administered different tests.
• Overlap between administration and evaluation time: A qualified professional cannot count the same minutes toward both administration (96136/96137) and evaluation ( 96130 / 96131 ) codes. During extended sessions, there may be natural transitions between administration and evaluation activities. Providers must clearly delineate when they are administering/scoring tests versus when they are interpreting, integrating, or preparing the evaluation report.
• Failing to document medical necessity for extended testing: When multiple units of 96137 are billed, payers may question whether the extended professional-administered testing was medically necessary. Documentation should include the clinical rationale for the comprehensive test battery, the specific diagnostic questions being addressed, and why the scope of testing required the time billed. For behavioral health patients, documenting the complexity of co-occurring conditions, the need to differentiate substance-related cognitive effects from independent conditions, or the requirements of a forensic or disability evaluation can support medical necessity.

Impact on Healthcare System

Impact on Patients

Extended testing sessions, captured through multiple units of 96137, enable comprehensive evaluations that provide the most thorough picture of a patient’s cognitive, emotional, and behavioral functioning. For patients in behavioral health settings, this thoroughness can be particularly valuable. Patients with substance use disorders who are being evaluated for co-occurring cognitive deficits, for example, benefit from extensive test batteries that can distinguish between substance-related cognitive effects and independent neurological or developmental conditions.

From a patient cost perspective, multiple units of 96137 can generate significant out-of-pocket expenses, especially for patients with high deductibles or coinsurance. Practices should inform patients about the anticipated scope and cost of testing before the evaluation begins, and verify insurance coverage for extended testing sessions. Some payers impose session limits or require prior authorization for testing that exceeds a certain number of units.

The patient experience during extended testing also matters. Multi-hour testing sessions can be fatiguing, and the qualified professional’s ability to monitor fatigue, adjust testing pace, and make clinical decisions about when to continue or pause testing is a significant advantage of professional-administered testing. These real-time clinical decisions are part of the professional value captured by 96137.

Impact on Providers

For providers, 96137 represents a significant portion of the revenue generated from comprehensive psychological and neuropsychological evaluations. A typical neuropsychological evaluation might generate one unit of 96136 plus three to six units of 96137, representing two to three-and-a-half hours of professional test administration time. Accurate billing of all qualifying 96137 units is essential for capturing the full value of the professional’s time.

Practice management decisions about testing models are directly affected by the economics of 96137. When the qualified professional administers tests personally (billing 96136/96137), the professional’s time is fully committed to that patient and cannot be used for other clinical services. The alternative model — having a technician administer tests ( 96138 / 96139 ) while the professional sees other patients — allows the professional to generate revenue from multiple patient encounters simultaneously. Each practice must weigh clinical quality, patient needs, and financial considerations in deciding how to structure their testing services.

The documentation burden for 96137 is proportional to the number of units billed. Extended sessions require detailed time logs, comprehensive identification of tests administered, and thorough behavioral observations. Practices that invest in documentation templates and structured time-tracking systems can reduce the administrative burden and improve billing accuracy.

Impact on Payers

Payers face increased cost exposure when providers bill multiple units of 96137 for extended testing sessions. As a result, utilization management programs often include edits and review criteria for psychological testing claims. Common payer controls include:

CMS publishes the Relative Value Units (RVUs) for 96137 in the annual Medicare Physician Fee Schedule, establishing the benchmark that many commercial payers use to set their own rates. ↗ Understanding the CMS rate-setting methodology helps providers anticipate payer behavior and prepare for utilization review.

• Prior authorization requirements for testing sessions expected to exceed a specified number of units
• Retrospective review of claims with high unit counts for 96137
• Comparison of professional administration (96136/96137) versus technician administration ( 96138 / 96139 ) patterns to assess whether professional administration is being used appropriately
• Frequency limits on neuropsychological testing per patient per time period

Billing Best Practices

Step-by-Step Billing Guide

• Confirm the base code is met first: Before billing any units of 96137, verify that all requirements for 96136 are satisfied — the qualified professional personally administered two or more standardized tests with at least 30 minutes of face-to-face time. The base code must be in place before any add-on units are counted.
• Track total face-to-face administration time precisely: Use a detailed time log that records start times, stop times, breaks, and interruptions throughout the testing session. Only face-to-face test administration and scoring time counts toward the time calculation. Exclude time spent on evaluation activities (interpretation, integration, reporting), breaks when not administering or scoring tests, and any other non-administration activities.
• Calculate additional 30-minute units: Subtract the first 30 minutes (assigned to 96136 ) from the total face-to-face administration and scoring time. Divide the remaining time into 30-minute increments. Apply the applicable time-rounding rules (generally, at least 16 minutes of the 30-minute increment must be completed to bill the additional unit). For example: 95 total minutes = 96136 x 1 (first 30 min) + 96137 x 2 (remaining 65 minutes qualifies for two additional 30-minute units because 65 minutes exceeds the 60-minute threshold for 2 units).
• Document tests administered and time allocation: The clinical record must specify which tests the qualified professional administered, the time spent on each test or testing segment, and the total face-to-face time supporting each billing unit. Include a clear time summary table or log that supports the unit calculation.
• Submit 96137 with 96136 on the same claim: Ensure the claim includes 96136 x 1 plus the appropriate number of 96137 units. Both codes should reflect the same date of service, same rendering provider, and same patient. If administration occurred over multiple dates, each date requires its own set of base-plus-add-on codes.
• Pair with evaluation and technician codes as appropriate: A comprehensive evaluation claim may include administration codes (96136/96137 and/or 96138 / 96139 ) plus evaluation codes ( 96130 / 96131 ). Ensure that time is not double-counted across these code families and that each code on the claim is supported by distinct, documented time.

Reimbursement Rates Overview

As of March 2026, reimbursement rates for 96137:

Note: Because multiple units of 96137 are commonly billed in a single session, the cumulative revenue from 96137 often exceeds the single-unit revenue from 96136. Accurate unit counting directly impacts total session reimbursement.

• Medicare: National average reimbursement is approximately $50-$65 per 30-minute unit, based on the Medicare Physician Fee Schedule. The rate for 96137 is slightly lower than 96136 because the add-on code carries lower practice expense RVUs (the startup costs of the testing session are captured in the base code). Geographic adjustments apply via the Geographic Practice Cost Index (GPCI).
• Medicaid: Rates vary by state, generally ranging from $35-$65 per 30-minute unit. Some states apply the same rate for 96136 and 96137, while others differentiate between the base and add-on codes.
• Commercial payers: Negotiated rates typically range from $55-$90 per 30-minute unit. Rates vary based on payer contracts, geographic region, and provider network tier.

Expert Tips

• Invest in a reliable time-tracking system: The single most impactful step for accurate 96137 billing is implementing a structured time-tracking process. Whether using a paper log, spreadsheet, or EHR-based timer, the system must capture face-to-face start and stop times for each testing segment and clearly distinguish administration time from evaluation time and from breaks.
• Pre-plan the test battery and estimate expected time: Before the testing session, plan the full test battery and estimate the expected administration time. This allows the practice to provide accurate cost estimates to patients, obtain prior authorization for the expected number of units, and schedule adequate time for the session.
• Document clinical rationale for session length: When billing three or more units of 96137, proactively document why the extended testing was clinically necessary. Reference the diagnostic complexity, the specific clinical questions requiring comprehensive testing, and the patient’s presentation that necessitated the full test battery.
• Understand payer-specific time-rounding rules: While CMS generally applies the midpoint rule (16 minutes out of 30), some commercial payers may use different rounding conventions. Verify the applicable rule for each payer to avoid systematic under-billing or over-billing.
• Coordinate with technician administration when appropriate: In sessions where some tests are administered by the professional and others by a technician, track the time separately for each provider type. The professional’s time supports 96136/96137, while the technician’s time supports 96138 / 96139. This mixed-model approach requires particularly careful documentation but is clinically and financially appropriate for many evaluation settings.

Compliance and Regulation

Key Laws and Policies

Health Insurance Portability and Accountability Act ( HIPAA ): All documentation supporting 96137 billing — including time logs, test protocols, scoring sheets, and behavioral observations — constitutes protected health information. Extended testing sessions generate substantial documentation that must be stored, transmitted, and disposed of in compliance with HIPAA requirements. Additionally, raw test data and test protocols are subject to ethical guidelines regarding their security and access.

False Claims Act (FCA): Overbilling 96137 units — billing for more time than the qualified professional actually spent on face-to-face test administration and scoring — is a potential False Claims Act violation. The FCA applies to claims submitted to federal healthcare programs (Medicare, Medicaid) and can result in treble damages and per-claim penalties. Common FCA risks related to 96137 include billing units based on total session time rather than net face-to-face administration time, rounding up time that does not meet the applicable threshold, and billing 96137 when the professional was not actually present and administering tests during the claimed time.

Mental Health Parity and Addiction Equity Act (MHPAEA): Payer limitations on the number of 96137 units allowed per session or per evaluation must comply with MHPAEA parity requirements when the testing relates to mental health or substance use disorder treatment. If a payer imposes stricter limitations on psychological testing units than on comparable medical/surgical testing units, this may constitute a parity violation. SAMHSA provides guidance on mental health parity compliance for behavioral health providers. ↗

Risks of Non-Compliance

• Recoupment of claims where 96137 units were overbilled based on inaccurate time tracking
• False Claims Act liability for systematically billing more 96137 units than supported by face-to-face time
• Audit exposure when claims show unusually high numbers of 96137 units per session
• Professional ethics complaints for billing misrepresentation
• Payer post-payment review demands requiring detailed time logs for each testing session
• Exclusion from federal healthcare programs for patterns of abusive billing

10-Point Compliance Checklist

• Verify that 96136 is included on every claim that contains 96137
• Maintain detailed face-to-face time logs for every testing session, with start/stop times for each testing segment
• Calculate 96137 units based on net face-to-face administration and scoring time, not total session duration
• Apply the correct time-rounding rules for the applicable payer (generally the midpoint rule for CMS)
• Ensure the same qualified professional is identified for both 96136 and all associated 96137 units
• Document clinical rationale for the scope of testing that supports the number of 96137 units billed
• Distinguish administration time (96136/96137) from evaluation time ( 96130 / 96131 ) in all documentation
• Obtain prior authorization when required by the payer for extended testing sessions
• Conduct regular internal audits comparing billed 96137 units to documented face-to-face time
• Train all billing staff on the time-tracking and unit-calculation requirements specific to add-on codes

Future Trends and Updates

Key trends affecting the future of 96137 and extended test administration billing:

• Automated time-tracking in EHR systems: Electronic health record platforms are increasingly integrating real-time timers and structured time-logging features specifically designed for psychological testing sessions. These tools can automatically calculate 96137 units based on documented face-to-face time, reducing calculation errors and strengthening audit documentation.
• Payer scrutiny of high-unit testing claims: Data analytics capabilities available to payers continue to advance, enabling more sophisticated identification of outlier billing patterns. Practices that routinely bill high numbers of 96137 units should maintain robust documentation and be prepared for retrospective review. Proactive compliance auditing is the best defense.
• Telehealth-adapted extended testing: As telehealth-administered testing becomes more established, questions arise about how 96137 applies to remotely administered testing sessions. Some tests can be administered via videoconference while maintaining standardized procedures, and payer policies on telehealth-based 96137 billing continue to evolve.
• Cognitive testing in substance use treatment: Growing recognition of the cognitive effects of substance use disorders is driving increased demand for neuropsychological testing in behavioral health settings. Comprehensive cognitive evaluations for patients in substance use treatment often require extended test batteries, generating multiple units of 96137. HHS has emphasized the importance of comprehensive assessment in substance use disorder treatment. ↗
• Value-based care models and testing efficiency: As healthcare payment models shift toward value-based arrangements, there may be pressure to optimize the efficiency of testing sessions. Providers will need to balance the clinical need for comprehensive testing (supporting multiple 96137 units) with payer expectations for cost-effective evaluation approaches.

Conclusion

CPT code 96137 is the essential add-on code that captures the extended professional time invested in comprehensive psychological and neuropsychological test administration. Without 96137, providers would be limited to billing only 30 minutes of professional administration time regardless of how long the evaluation actually takes, resulting in significant under-reimbursement for the qualified professional’s clinical work.

For behavioral health providers, accurate 96137 billing depends on three core practices: precise face-to-face time tracking, correct unit calculation using applicable rounding rules, and thorough documentation of the clinical rationale for extended testing. Practices that invest in structured time-tracking systems and staff training on add-on code requirements will be well-positioned to bill compliantly and capture the full value of their testing services.

Additional Resources

• Revenue Cycle Management Best Practices for Behavioral Health — Billing workflow optimization
• Compliance Essentials for Behavioral Health Providers — Regulatory framework overview
• Insurance Billing Guides Hub — Complete billing code reference
• Treatment Planning for Behavioral Health — Integrating assessment into care plans

Related Billing Codes

• 96130
• 96131
• 96136
• 96138
• 96139
• 96156

Common questions

Official sources

• The American Psychological Association estimates that comprehensive neuropsychological evaluations, which include extensive test batteries administered over multiple hours, are essential for diagnosing complex cognitive and behavioral conditions, particularly in populations with co-occurring substance use and mental health disorders.apa.org
• CMS publishes the Relative Value Units (RVUs) for 96137 in the annual Medicare Physician Fee Schedule, establishing the benchmark that many commercial payers use to set their own rates.cms.gov
• SAMHSA provides guidance on mental health parity compliance for behavioral health providers.hhs.gov
• HHS has emphasized the importance of comprehensive assessment in substance use disorder treatment.hhs.gov