Need help choosing the right code?
Ask CasePilot about procedures, modifiers, bundling, and coding guidance.
Try CasePilot© Copyright 2026 American Medical Association. All rights reserved.
The CPT® Code 96137 pertains to the administration and scoring of psychological or neuropsychological tests conducted by a physician or other qualified healthcare professional. This code specifically applies when two or more tests are administered, and it is used to report the additional time spent beyond the initial 30 minutes of testing. Psychological and neuropsychological testing is essential for evaluating cognitive functions, mental health conditions, and potential impairments. Standardized tests such as the Halstead-Reitan Neuropsychological Battery, Wechsler Memory Scales, and Wisconsin Card Sorting Test are commonly utilized in these assessments. The process involves a face-to-face encounter where the qualified professional selects the appropriate tests, administers them, and derives both raw and standardized scores. It is important to note that the initial 30 minutes of test administration and scoring is reported using CPT® Code 96136, while each subsequent 30-minute increment is reported with CPT® Code 96137. This structured approach ensures that the time spent on testing is accurately captured for billing and reimbursement purposes, reflecting the complexity and thoroughness of the evaluation process.
© Copyright 2026 Coding Ahead. All rights reserved.
The indications for utilizing CPT® Code 96137 include a variety of psychological and neuropsychological assessments aimed at evaluating cognitive and mental functions. These assessments are typically indicated for the following conditions:
The procedure for administering psychological or neuropsychological tests under CPT® Code 96137 involves several key steps, which are detailed below:
Post-procedure care following the administration of psychological or neuropsychological tests typically involves the interpretation of the test results by the qualified healthcare professional. After scoring, the professional will analyze the data to provide a comprehensive evaluation of the patient's cognitive and psychological functioning. This evaluation may lead to recommendations for further treatment, interventions, or referrals to other specialists if necessary. Additionally, a written report summarizing the findings and recommendations is often prepared for the patient and any relevant stakeholders, such as referring physicians or educational institutions. Follow-up appointments may be scheduled to discuss the results and any subsequent steps in the patient's care plan.
| Short Descr | PSYCL/NRPSYC TST PHY/QHP EA | Medium Descr | PSYCL/NRPSYCL TST PHYS/QHP 2+ TST EA ADDL 30 MIN | Long Descr | Psychological or neuropsychological test 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) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 04 - Physician supervision policy does not apply when procedure is furnished by a qualified, independent psychologist... | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | Berenson-Eggers TOS (BETOS) | none | MUE | 11 |
| 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | AH | Clinical psychologist | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | UC | Medicaid level of care 12, as defined by each state | GW | Service not related to the hospice patient's terminal condition | TF | Intermediate level of care | CR | Catastrophe/disaster related | HP | Doctoral level | FQ | The service was furnished using audio-only communication technology | GC | This service has been performed in part by a resident under the direction of a teaching physician | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 93 | Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system : synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located away at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that is sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. | GZ | Item or service expected to be denied as not reasonable and necessary | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | HO | Masters degree level | GQ | Via asynchronous telecommunications system | U7 | Medicaid level of care 7, as defined by each state | GA | Waiver of liability statement issued as required by payer policy, individual case | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | X1 | Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care | Q2 | Demonstration procedure/service | U6 | Medicaid level of care 6, as defined by each state | QJ | Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b) | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | AJ | Clinical social worker | GT | Via interactive audio and video telecommunication systems | HN | Bachelors degree level | 25 | Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 96 | Habilitative services: when a service or procedure that may be either habilitative or rehabilitative in nature is provided for habilitative purposes, the physician or other qualified health care professional may add modifier 96 to the service or procedure code to indicate that the service or procedure provided was a habilitative service. habilitative services help an individual learn skills and functioning for daily living that the individual has not yet developed, and then keep and/or improve those learned skills. habilitative services also help an individual keep, learn, or improve skills and functioning for daily living. | AM | Physician, team member service | GB | Claim being re-submitted for payment because it is no longer covered under a global payment demonstration | KX | Requirements specified in the medical policy have been met | PC | Wrong surgery or other invasive procedure on patient | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q5 | Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | U4 | Medicaid level of care 4, as defined by each state | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2019-01-01 | Added | Added |
Get instant expert-level medical coding assistance.