Evaluation of psychological test, each additional hour
Medicare pricing data for 2,350 providers across 49 states
Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Evaluation of psychological test, each additional hour (HCPCS code 96131) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $83.74, but hospitals typically charge $172.69 — a 2.1x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $83.74, your out-of-pocket cost would be approximately $16.75. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 2.1x more than what Medicare allows for this procedure. Medicare actually pays $66.42 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $118 | $342 | 6 | 99 | +41.1% |
| District of Columbia | $93 | $102 | 5 | 205 | +11.4% |
| New York | $91 | $181 | 56 | 869 | +8.1% |
| Rhode Island | $88 | $187 | 14 | 146 | +5.4% |
| Oregon | $87 | $175 | 22 | 1,247 | +3.3% |
| Connecticut | $86 | $164 | 10 | 148 | +3.2% |
| Maryland | $86 | $212 | 21 | 196 | +3.1% |
| Massachusetts | $86 | $177 | 46 | 1,460 | +2.5% |
| Florida | $86 | $162 | 130 | 5,335 | +2.5% |
| California | $85 | $155 | 268 | 20,172 | +1.8% |
| Montana | $85 | $164 | 6 | 65 | +1.7% |
| Hawaii | $85 | $212 | 5 | 26 | +1.5% |
| Wyoming | $85 | $198 | 13 | 187 | +1.5% |
| New Jersey | $85 | $137 | 37 | 2,034 | +1.4% |
| Nevada | $85 | $171 | 21 | 1,516 | +1.0% |
| Illinois | $84 | $219 | 104 | 1,420 | +0.8% |
| Colorado | $84 | $138 | 31 | 1,065 | +0.3% |
| Washington | $84 | $206 | 43 | 395 | +0.0% |
| Vermont | $84 | $281 | 4 | 77 | -0.2% |
| Texas | $83 | $173 | 190 | 7,306 | -0.9% |
| Idaho | $83 | $161 | 9 | 114 | -1.3% |
| New Mexico | $83 | $160 | 17 | 137 | -1.3% |
| Minnesota | $82 | $231 | 110 | 900 | -1.5% |
| Oklahoma | $82 | $137 | 25 | 1,472 | -1.6% |
| Utah | $82 | $185 | 29 | 568 | -1.6% |
| Virginia | $82 | $192 | 86 | 850 | -1.8% |
| Kentucky | $82 | $172 | 27 | 1,704 | -1.8% |
| Pennsylvania | $82 | $186 | 68 | 673 | -1.9% |
| North Carolina | $82 | $175 | 114 | 1,772 | -2.4% |
| Mississippi | $82 | $148 | 21 | 286 | -2.6% |
| South Dakota | $81 | $213 | 22 | 356 | -2.8% |
| Arkansas | $81 | $209 | 17 | 391 | -2.9% |
| Maine | $81 | $184 | 13 | 150 | -2.9% |
| Louisiana | $81 | $143 | 25 | 159 | -3.0% |
| West Virginia | $81 | $136 | 20 | 184 | -3.1% |
| Georgia | $81 | $197 | 79 | 1,041 | -3.1% |
| Michigan | $81 | $239 | 129 | 1,845 | -3.7% |
| Kansas | $80 | $251 | 31 | 1,014 | -4.1% |
| Arizona | $80 | $170 | 42 | 2,147 | -4.2% |
| Iowa | $80 | $294 | 27 | 101 | -4.6% |
| Indiana | $80 | $197 | 47 | 491 | -4.6% |
| Tennessee | $80 | $163 | 34 | 809 | -4.6% |
| Wisconsin | $80 | $329 | 57 | 507 | -4.7% |
| Ohio | $80 | $164 | 69 | 1,204 | -4.7% |
| Missouri | $80 | $183 | 56 | 603 | -4.8% |
| South Carolina | $80 | $218 | 24 | 508 | -4.8% |
| Nebraska | $80 | $255 | 28 | 452 | -5.0% |
| North Dakota | $79 | $196 | 23 | 184 | -5.8% |
| Alabama | $77 | $135 | 29 | 772 | -7.5% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber