Summary & Overview

CPT 96138: Psychological Test Administration and Scoring by Technician

CPT code 96138 represents the administration and scoring of psychological or neuropsychological tests by a technician, covering two or more tests for the first 30 minutes. This code is widely used in outpatient psychiatric and psychology settings to support the evaluation of cognitive, emotional, and behavioral conditions. Nationally, the code is recognized by major payers including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare, reflecting its importance in behavioral health billing and reimbursement.

Readers will gain insight into the clinical context of psychological and neuropsychological testing, the typical site of service, and the scope of technician-led test administration. The publication also covers relevant policy updates, payer coverage, and associated coding benchmarks. Understanding 96138 is critical for professionals involved in behavioral health services, as it ensures proper documentation and billing for technician-administered testing procedures. The summary provides a comprehensive overview of the code's role in national healthcare policy and its impact on clinical practice.

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CPT Code Overview

CPT code 96138 is used for the administration and scoring of psychological or neuropsychological tests by a technician. This code applies when two or more tests are administered by any method, and covers the first 30 minutes of testing. The service type is Psychological and Neuropsychological Testing – Test Administration by Technician, typically performed in a psychiatric or psychology outpatient setting. This code is essential for documenting and billing technician-led test administration, supporting accurate assessment and care planning in behavioral health and neurology practices.

Clinical & Coding Specifications

Clinical Context

A patient presents to a psychiatric or psychology outpatient setting with cognitive concerns related to conditions such as human immunodeficiency virus (HIV) disease or vascular dementia. The provider determines that psychological or neuropsychological testing is necessary to assess cognitive function, mood, or behavioral status. A technician administers and scores two or more standardized tests over a 30-minute period, using paper, electronic, or other methods. The results are used to inform diagnosis and treatment planning by the supervising clinician.

Coding Specifications

Modifiers:
- Modifier 26: Indicates the professional component of the service, typically used when the provider is responsible for interpretation and reporting but not the technical performance.
- Modifier 59: Used to denote a distinct procedural service, indicating that the testing is separate from other services provided on the same day.
Provider Taxonomies:

Taxonomy Code Specialty

National Reimbursement Benchmarks

For CPT code 96138, the national mean rate for Medicare is $39.50, which is notably lower than the BUCA (average commercial) mean rate of $48.80. Commercial payers such as UnitedHealth Group and Cigna report even higher mean rates, at $59.97 and $54.91 respectively, while Aetna and Blue Cross Blue Shield are closer to the Medicare average.

Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies significantly across payers. Medicare exhibits the tightest range at $5.00, indicating relatively consistent reimbursement. In contrast, UnitedHealth Group shows the widest spread at $34.00, followed by Cigna at $25.00, reflecting greater variability in commercial rates. The table and chart below present the full breakdown of national benchmarks for each payer.

National Mean Rates for CPT Code `96138` by Payer

Related CPT Codes

CPT Code	Description	Relationship to `96138`
`96136`	Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; first 30 minutes	Used when a physician or qualified health care professional, rather than a technician, administers the tests. Alternative to `96138` depending on personnel.
`96137`	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	Used for additional time beyond the first 30 minutes when administered by a physician or qualified health care professional. Often paired with `96136`.
`96139`	Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; each additional 30 minutes	Used for each additional 30 minutes of testing by a technician. Commonly used with `96138` for extended testing sessions.
`96146`	Psychological or neuropsychological test administration, with single automated, standardized instrument via electronic platform, with automated result only	Used for automated testing via electronic platforms. Alternative to manual technician-administered testing.

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Summary & Overview

CPT 96138: Psychological Test Administration and Scoring by Technician

CPT Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

National Reimbursement Benchmarks

Related Codes

Related Diagnoses

Related CPT Codes

National Reimbursement Benchmarks

Related Codes