The #1 AI-powered therapy

notes – done in seconds

Try for free

The #1 AI-powered therapy notes – done in seconds

Try for free

This blog is brought to you by YUNG Sidekick –

the #1 AI-powered therapy notes – done in seconds

This blog is brought to you by YUNG Sidekick — the #1 AI-powered therapy notes – done in seconds

Try for free – no credit card required

Back to blog

CPT 96137: What Medical Billers Need to Know in 2025

Stanley Efrem

Jun 10, 2025

CPT 96137 changed psychological testing billing after the Centers for Medicare & Medicaid Services (CMS) retired older codes in 2019. This major coding update replaced CPT codes 96103 and 96101 with new options including 96136, 96138, 96146, and 96130 that altered how providers report these vital services.

Medical billers must understand psychological testing CPT codes to ensure proper reimbursement. CPT code 96137 covers the administration and scoring of each additional unit of psychological testing after the first hour shown by CPT code 96136. These tests typically last between 30 to 90 minutes, and accurate time tracking remains vital for 96137 CPT code reimbursement. On top of that, CMS has confirmed that billing for certain psychological testing codes, including CPT code 96136 and 96137, will continue through telemedicine until 2025. This piece will help you understand everything about using these codes correctly to ensure your practice's appropriate compensation while supporting quality mental health care.

What is CPT Code 96137 and When Is It Used?

Medical professionals need to understand CPT code 96137 to handle psychological testing procedures and medical billing protocols correctly. This code is a vital part of getting proper reimbursement when mental health professionals conduct psychological assessments.

Definition and scope of 96137

CPT 96137 means "Psychological or neuropsychological test administration and scoring by physician or other qualified healthcare professional, two or more tests, any method; each additional 30 minutes" [1]. You can only use this add-on code after reporting the main code (96136) for the first 30 minutes of service. The code covers administration and scoring of multiple psychological or neuropsychological tests after the original time block [2].

The code's scope includes standardized tests that measure cognitive functions, emotional status, and behavioral patterns. Clinicians use these assessments to diagnose conditions like depression, anxiety, ADHD, and other psychiatric disorders [1]. The code works for both face-to-face consultations and virtual sessions [2].

How it relates to CPT code 96136

You must always use CPT code 96137 together with code 96136. Code 96136 handles the first 30 minutes of test administration and scoring, while 96137 takes care of each extra 30-minute block needed to finish the service [3].

CPT time rules say you can bill another unit of 96137 once you pass the mid-point of the stated time. You need at least an additional 16 minutes of work beyond the first 30 minutes to bill one unit of 96137 [3]. Here's how it works:

45 minutes or less: Bill one unit of 96136
46-75 minutes: Bill one unit of 96136 and one unit of 96137
76-105 minutes: Bill one unit of 96136 and two units of 96137 [4]

Typical use cases in psychological testing

Healthcare providers typically use code 96137 in several clinical situations:

Patients who show symptoms of persistent sadness, anxiety, or mood swings
People with cognitive issues like memory loss or confusion
Cases that involve behavioral changes, including impulsivity or aggression
Learning disabilities or academic difficulties assessment
Brain injuries or neurological diseases evaluation [1]

The testing process starts with an assessment, followed by standardized tests and careful scoring based on established guidelines. Most testing sessions take 4-8 hours to complete, including administration and scoring [5]. When testing takes multiple days, providers should combine all time and report it on the service's last day.

How to Bill CPT 96137 Correctly

Billing CPT 96137 correctly needs a clear grasp of time-tracking protocols and documentation standards. You will get maximum reimbursement and stay compliant by mastering these details.

Time-based billing rules

CPT 96137 has strict time-based billing guidelines. This add-on code must always be reported with the primary code 96136 and never as a standalone service [6]. The total cumulative time should be reported after completing the entire testing episode if psychological testing spans multiple days [1]. Base codes like 96136 should be billed once during a testing episode. Subsequent units need billing using add-on codes (96137) even when services occur over multiple days [1].

Minimum time requirements for 96137

Specific time thresholds must be met to bill CPT 96137. CPT time rules let you report an additional unit once you pass the mid-point of the stated time [7]. Here's what this means:

At least 16 minutes beyond the first 30 minutes must be completed to bill one unit of 96137 [8]
Each additional 30-minute increment needs at least 16 minutes of that increment for multiple units [3]
You need a minimum of 31 minutes to report any per-hour code [5]

Examples of billing scenarios

Let's look at these practical billing scenarios:

For 45 minutes total: Bill only 96136 For 46-75 minutes: Bill 96136 plus one unit of 96137 [8] For 76-105 minutes: Bill 96136 plus two units of 96137

So if test administration and scoring takes 100 minutes, you would bill one unit of 96136 and two units of 96137.

Face-to-face vs. virtual sessions

CPT 96137 can be billed for both in-person and telehealth services, unlike what many believe [9]. Here's what you need to know about telehealth billing:

Use your typical code (96137) and add modifier 95 to show telehealth [9]
Medicare pays for telehealth services including audio-only (telephone) sessions [9]
Your notes should clearly state the delivery method for virtual services

These billing practices and proper documentation will help you get maximum reimbursement while meeting payer requirements.

Understanding Related Psychological Testing CPT Codes

The psychological testing CPT code family went through significant revisions in 2019. These changes created distinct categories that work together to capture testing services. Understanding how these codes interact helps you get proper reimbursement.

96136 and 96137: Admin by professional

Physicians, psychologists, and qualified healthcare professionals use CPT code 96136 to bill the first 30 minutes of test administration. Code 96137 applies to each additional 30-minute increment. These codes need:

Administration of two or more tests using any method
A minimum of 16 minutes to bill each 30-minute unit
Documentation of total time spent on test administration and scoring

Test scoring time now counts as billable time, which differs from previous coding structures [10].

96138 and 96139: Admin by technician

The technician-administered testing follows a pattern like in professional codes. Code 96138 covers the first 30 minutes and 96139 applies to each additional half-hour. These codes:

Apply to tests administered by technicians under professional supervision
Bill based on face-to-face patient time [10]
Cannot be billed with 96136/96137 on the same day without proper modifiers [11]

Your practice needs modifier XE for separate encounters or modifier 59 for same-encounter services if both psychologist and technician administer tests on the same day [11].

96130 and 96131: Evaluation services

These codes represent qualified professionals' interpretive work:

96130 bills the first hour of psychological testing evaluation
96131 covers each additional hour
Both include data integration, result interpretation, treatment planning, and feedback

You should submit the primary code 96130 once during evaluation, then use add-on code 96131 for additional units [11].

96146: Automated testing

CPT 96146 specifically applies to:

Single automated psychological instruments on electronic platforms
Tests generating automated results without professional help
One-time billing regardless of test completion time [10]

This code does not apply to multiple electronic test administration or professional/technician-conducted tests [12].

Reimbursement, Compliance, and Documentation Tips

Getting paid for psychological testing depends on following coding rules and keeping detailed records. These elements help you stay compliant and get the right payment for your work.

96137 CPT code reimbursement guidelines

The CPT code 96137 pays about $55-$65 for each 30-minute block [13]. You can't bill this add-on code by itself—it needs the base code 96136 first. Tests that take multiple days need one claim after all testing ends [1]. Your claim should show both base and add-on codes with different service dates tied to the full evaluation [1].

The National Correct Coding Initiative (NCCI) has rules for billing psychological tests over several sessions. You should report the total time spent on each service type once testing finishes [11]. Use one base code (96136) for the first service unit and the add-on code 96137 for extra units [1].

Common billing errors to avoid

Claims often get denied because of specific mistakes that create compliance risks. Don't bill multiple base code units during one testing period, even with multi-day testing [1]. Time tracking errors are also common since these codes need specific minute-by-minute records [13].

Some providers bill 96136 and 96137 separately from evaluation codes (96130-96133). A complete test episode must include both evaluation and test administration/scoring codes [1]. Using different provider ID numbers for billing parts of the same service might trigger audit concerns [14].

Documentation best practices for audits

Good records protect you during audits. Your medical files must show why the testing was needed for diagnosis and treatment plans [15]. Your records should have:

Exact start and end times for each service [16]
Tests administered, scoring, and interpretation [15]
Reason for referral and diagnosis (or suspected diagnosis) [15]
Recommendations for interventions when appropriate [15]
Identity of the person performing each service [15]

Psychological testing takes 4-8 hours to finish, including administration and scoring [5]. Keep detailed time records to support your billing claims and get paid smoothly.

Conclusion

Medical billers must become skilled at using CPT code 96137 to get accurate reimbursement for psychological testing services. This code works with primary code 96136 and belongs to the 4-year old family of psychological testing codes.

Time tracking makes the biggest difference in billing 96137 correctly. Each unit needs at least 16 minutes beyond the first 30-minute period. The documentation must show exact start and end times, test details, and names of professionals who gave the tests.

You can easily avoid common billing mistakes by following the coding rules closely. To cite an instance, never use 96137 by itself. When tests take multiple days, submit one complete claim after finishing the whole testing process.

The payment usually ranges from $55-$65 per 30-minute block, but your actual reimbursement depends on complete documentation and meeting payer requirements. Both in-person and telehealth services qualify for 96137 billing, though telehealth needs the right modifier.

These guidelines will help you direct the complex world of psychological testing billing. Using these practices supports your facility's financial health and gives patients better access to vital mental health services. Accurate billing makes psychological testing accessible to more people who need it most.

FAQs

How many units of CPT code 96137 can be billed in a day?

Multiple units of 96137 can be billed, with a maximum of 6 hours allowed per day. Each unit represents an additional 30 minutes beyond the initial hour covered by 96136.

What is the difference between CPT codes 96136 and 96137?

CPT code 96136 covers the first 30 minutes of psychological test administration and scoring by a qualified professional. CPT code 96137 is an add-on code for each additional 30-minute increment beyond the initial period.

Can CPT code 96137 be billed for telehealth services?

Yes, CPT code 96137 can be billed for both in-person and telehealth services. When billing for telehealth, add modifier 95 to indicate a virtual session.

What documentation is required for billing CPT code 96137?

Documentation should include exact start and end times, tests administered, scoring details, reason for testing, diagnosis or suspected diagnosis, and the identity of the professional performing the service.

How does reimbursement work for CPT code 96137?

Reimbursement for CPT 96137 typically ranges from $55 to $65 per 30-minute increment. It must be billed in conjunction with the base code 96136 and cannot be billed independently. When testing spans multiple days, submit one comprehensive claim upon completion of the entire testing episode.