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What Is CPT Code 96133? A Simple Guide for Medical Billing

Stanley Efrem

Jun 9, 2025

CPT code 96133 serves a vital part in medical billing for mental health services, particularly neuropsychological testing evaluations. Global statistics show that one in eight people live with a mental disorder, which makes accurate billing for psychological services more critical than ever for healthcare providers.

Healthcare underwent a transformation on January 1, 2019, when new CPT codes emerged to describe assessment services by psychologists more accurately. CPT code 96133 specifically covers each additional hour of neuropsychological testing evaluation services after the original hour. Your practice needs to understand what CPT code 96133 means to receive proper reimbursement. These evaluations take time and resources. A clear grasp of whether CPT code 96133 applies to behavioral health and its definition helps ensure appropriate compensation while you retain control of billing compliance.

This piece explains everything about this valuable add-on code. You'll discover how to use it correctly and learn best practices that maximize your reimbursements. The content also helps you avoid common billing mistakes that could cost your practice money.

What is CPT Code 96133?

CPT code 96133 definition and purpose

The Current Procedural Terminology (CPT) code 96133 is part of the medical code set that the American Medical Association manages under the Psychological and Neuropsychological Testing Evaluation Services category. Healthcare providers use this code to represent "each additional hour" of neuropsychological testing evaluation services performed by a physician or other qualified healthcare professional (QHP).

This add-on code helps healthcare providers bill for time spent beyond the first hour of neuropsychological evaluation. The code covers several professional activities. These activities include patient data integration, standardized test result interpretation, clinical decision making, treatment planning, report preparation, and interactive feedback to patients, family members, or caregivers.

How it relates to CPT 96132

Healthcare providers must report CPT code 96133 with the primary code 96132. Code 96132 covers the first hour of neuropsychological testing evaluation services, while 96133 applies to each additional hour after that period.

Providers need to perform at least 31 minutes of additional work beyond the first hour to bill one unit of the add-on code 96133. These codes follow a time-based structure that lets providers track the work required in neuropsychological evaluations accurately.

When to use 96133 in clinical settings

Neuropsychological testing takes 4-8 hours to complete with administration and scoring. Providers should combine all testing time and report it on the last service day if testing spans multiple days.

Healthcare providers can use CPT code 96133 in clinical settings where they conduct detailed neuropsychological assessments to evaluate the central nervous system's cognitive function. The code applies when:

Assessment time goes beyond one hour
A physician or QHP performs the evaluation services directly
The evaluation has data integration and interpretation
The provider offers treatment planning and feedback

Behavioral health professionals use this code especially when they examine cognitive functions like memory, attention, language, and executive functioning.

Understanding Add-On Code Rules

Healthcare providers need to follow specific guidelines in the billing structure of neuropsychological testing services to receive proper reimbursement. Let's get into the technical aspects of CPT code 96133 and how you can apply it.

What makes 96133 an add-on code

Add-on codes cover additional services beyond primary codes. CPT code 96133 works as an add-on code that providers cannot bill independently - they must report it with its primary code, 96132 [1]. The American Medical Association created this structure in 2019 to improve how psychological testing codes represent clinical work [2].

The cpt code 96133 description shows it covers "each additional hour" of neuropsychological testing evaluation services. This add-on code helps providers document their work that goes beyond the first hour.

Minimum time requirements for billing

Strict time requirements guide the billing of CPT code 96133. CPT Time Rules state that providers need at least 31 minutes of extra service after the first hour to bill the first unit of 96133 [3][4]. The first hour falls under 96132.

To cite an instance, see:

1 hour 30 minutes total service = 96132 (first hour) + 96133 x1 (additional 30 minutes)
2 hours 15 minutes total service = 96132 (first hour) + 96133 x2 (additional 1 hour 15 minutes)

This minimum threshold applies to each extra unit of 96133 that providers bill.

How to combine 96132 and 96133 correctly

Here are the key rules to remember:

A complete neuropsychological testing episode must include both evaluation codes (96132/96133) and test administration codes (96136/96137 or 96138/96139) [1]. On top of that, providers should bill the base code 96132 only once during a testing episode, even with multi-day testing [1].

Services that span several days need combined testing time reported on the last service day [5]. If evaluation services happen over three days, you would bill 96132 on day one and 96133 on later days for extra time [6].

What does cpt code 96133 mean in practice? The code represents ongoing professional work that includes data integration, results interpretation, clinical decision-making, and treatment planning after the first hour [7].

Who Can Bill CPT Code 96133?

Medical professionals need to understand qualification requirements and supervision standards to bill CPT code 96133 correctly. This understanding leads to proper reimbursement and compliance with regulations.

Qualified healthcare professionals (QHPs)

CPT code 96133 billing isn't limited to physicians. Clinical psychologists, nurse practitioners (NPs), clinical nurse specialists (CNSs), physician assistants (PAs), and other non-physicians can bill this code too. These professionals must work within their clinical practice scope and education. They also need proper licensing and authorization under state law.

The meaning of what does cpt code 96133 mean stays consistent among different providers. The code represents the same neuropsychological evaluation services no matter who performs them. Each provider needs a Medicare provider number and state licensure to bill Medicare for these services.

Supervision requirements for technicians

Technicians can administer neuropsychological tests with proper supervision. Medicare regulations state that physicians or clinical psychologists must provide general supervision for these diagnostic tests. The supervisor doesn't need to be physically present during the procedure but remains responsible for the service.

The QHP's responsibilities include selecting instruments, interpreting data, writing reports, and giving interactive feedback. This applies even when technicians administer the tests. The supervisor must assess patient responses through direct observation or communication with the technician.

Payer-specific restrictions and exceptions

Each payer sets its own criteria to reimburse neuropsychological testing. Medicare won't pay for services under cpt code 96133 description if students or trainees perform them. A qualified provider can still get paid if a student or trainee watches the administration, as long as the QHP stays responsible for the service.

Commercial payers might have different requirements from CMS guidelines. Healthcare providers should check payer-specific policies before submitting claims. This practice helps meet documentation and coding standards and reduces claim denials.

Documentation and Billing Best Practices

Good documentation forms the foundations of successful neuropsychological testing billing. You can reduce claim denials and get better reimbursement by becoming skilled at the requirements for CPT code 96133.

Time tracking and log sheet requirements

CPT code 96133 billing needs strict adherence to time-based requirements. You need at least 31 minutes of additional work beyond the first hour (96132) to bill one unit of 96133 [3]. This makes detailed time tracking crucial.

Your documentation needs to show:

Start and end times for each testing component
Total minutes spent on evaluation activities
Dates of service for multi-day testing

The testing time should be combined and reported on the last day of service when testing takes multiple days [5]. Your notes should include enough detail about services and support medical necessity for everything you do [8].

Avoiding common billing errors

These common billing mistakes with CPT code 96133 lead to denials and payment delays:

Submitting the add-on code without its primary code (96132) on the same claim form
Mismatching CPT and ICD-10 diagnostic codes [9]
Not enough documentation of time spent and activities
Missing the minimum time threshold of 31 minutes

The medical record should explain why testing helps diagnosis and treatment planning [10]. Each page must have the patient's identification and your readable signature.

Using modifiers with 96133 when needed

Some situations need modifiers to get proper reimbursement. Add Modifier XE to the base code for the second encounter if testing services happen during separate encounters on the same date [11]. Use Modifier 59 for services during the same encounter but as distinct procedural services [11].

The National Correct Coding Initiative (NCCI) edits stop improper payments by ensuring correct coding methods [11]. Your documentation must back up any modifier use with a clear explanation of services and their medical necessity [6].

Careful documentation and knowing the billing rules will help you get fair compensation for your valuable neuropsychological evaluation services under CPT code 96133.

Conclusion

Healthcare providers who perform neuropsychological testing evaluations need to understand CPT code 96133 completely. This piece has taught you that this add-on code covers each extra hour after the original evaluation period under code 96132. Of course, becoming skilled at time requirements—particularly the 31-minute minimum threshold for billing each unit—helps you get the right reimbursement for your services.

Clinical psychologists, nurse practitioners, and physician assistants can bill this code within their practice scope. Documentation is the life-blood of successful billing. Your time tracking should be precise and show clear start and end times that prove medical necessity for all services.

Payment delays and frustration stem from billing errors. Note that you should always pair 96133 with its primary code 96132 on the same claim form. Your diagnostic codes should match appropriately with really clear documentation. On top of that, you should combine all testing time and report it on the final service day for multi-day testing scenarios.

The healthcare billing world keeps changing. Proper coding practices protect your practice and ensure fair pay for your valuable neuropsychological services. This knowledge about CPT code 96133 lets you handle neuropsychological testing billing with confidence and precision. You ended up supporting better patient care through proper resource allocation.

FAQs

Can CPT code 96133 be billed independently?

No, CPT code 96133 cannot be billed alone. It is an add-on code that must always be reported in conjunction with the primary code 96132, which represents the first hour of neuropsychological testing evaluation services.

What is the minimum time requirement for billing CPT code 96133?

To bill CPT code 96133, providers must perform at least 31 minutes of additional work beyond the first hour (which is billed under 96132). This minimum threshold applies to each additional unit of 96133 billed.

Who is qualified to bill for CPT code 96133?

Qualified healthcare professionals (QHPs) such as physicians, clinical psychologists, nurse practitioners, clinical nurse specialists, and physician assistants can bill for CPT code 96133. These professionals must provide services within their clinical practice scope and be licensed and authorized under state law.

How should time be tracked for billing CPT code 96133?

Detailed time tracking is essential. Documentation should clearly indicate start and end times for each testing component, total minutes spent on evaluation activities, and dates of service for multi-day testing. When testing spans multiple days, all testing time should be combined and reported on the last day of service.

What are common billing errors to avoid with CPT code 96133?

Common billing errors include submitting the add-on code without its primary code (96132) on the same claim form, mismatching CPT and ICD-10 diagnostic codes, insufficient documentation of time spent and activities performed, and not meeting the minimum time threshold of 31 minutes. Avoiding these errors can help prevent claim denials and delayed payments.