CPT 96137 Reimbursement & Policy Benchmarks

Find policies, billing codes, payers, states, and providers

National Reimbursement Benchmarks

Nationally, Medicare averages $38.6 for CPT 96137 while BUCA’s average commercial rate sits higher at $43.8, indicating commercial payment levels above Medicare by about $5.2 on average. Blue Cross Blue Shield ($33.7 mean) and Aetna ($62.5 mean) bracket the commercial spectrum, with UnitedHealth Group showing the highest commercial mean at $54.8 and Cigna at $44.8.

Dispersion measured as the interquartile spread (P75 minus P25) is tightest for Blue Cross Blue Shield at $18.5 and for Aetna at $27.9, while UnitedHealth Group and Cigna display wider spreads of $36.5 and $28.4 respectively, indicating more variability in allowed amounts among those carriers. BUCA’s IQR is $24.7 and Medicare’s IQR is $4, reflecting very localized consistency across Medicare localities.

Explore openpayer tools

View all tools

Find policies, billing codes, payers, states, and providers

National Reimbursement Benchmarks

National Payer Mean Reimbursement Rates

CPT 96136: Psychological/Neuropsychological Test Administration and Scoring, First 30 Minutes

CPT-96138-TECHNICIAN-TEST-ADMINISTRATION-SCORING-30-MINUTES

CPT 96138: Technician Administration and Scoring of Multiple Tests, First 30 Minutes

CPT-96139-TECHNICIAN-TEST-ADMINISTRATION-SCORING-ADDITIONAL-30-MINUTES

CPT 96139: Technician Administering and Scoring Tests, Additional 30 Minutes

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Explore openpayer tools

View all tools

OpenPayer

National Reimbursement Benchmarks

OpenPayer

National Reimbursement Benchmarks

Related Codes

References

Related Codes

References