96136

Administration of psychological or neuropsychological test, first 30 minutes

Medicare pricing data for 6,084 providers across 52 states

🤖AI Overview

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

Administration of psychological or neuropsychological test, first 30 minutes (HCPCS code 96136) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $38.75, but hospitals typically charge $126.62 — a 3.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.75

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $38.75, your out-of-pocket cost would be approximately $7.75. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$38.75
Average Hospital Charge
$126.62
Markup Ratio
3.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$126.62
Medicare Allowed$38.75
Medicare Payment$30.03

Hospitals charge 3.3x more than what Medicare allows for this procedure. Medicare actually pays $30.03 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Hawaii$45$12619149+15.5%
New York$45$1913197,615+15.0%
New Jersey$44$1441783,118+13.0%
Delaware$42$12018715+8.7%
Puerto Rico$42$49978+7.7%
Wyoming$42$97836+7.5%
Vermont$42$10511308+7.3%
California$42$13863723,002+7.1%
Connecticut$41$145961,795+6.3%
District of Columbia$41$10426429+5.7%
Washington$41$125861,834+4.9%
Florida$40$12045120,645+3.2%
Alaska$40$19211234+3.0%
Massachusetts$40$1351693,752+2.5%
New Hampshire$40$166301,125+2.2%
Texas$39$12656023,760+1.3%
Colorado$39$1061451,876+0.9%
Idaho$39$9926410+0.7%
Rhode Island$39$11241629+0.1%
Minnesota$39$1491421,292-0.3%
Georgia$39$1291842,747-0.4%
Nebraska$39$12934368-0.6%
Illinois$38$1252916,310-1.3%
Pennsylvania$38$1082776,507-1.4%
New Mexico$38$9148473-2.0%
Indiana$38$1001031,342-2.2%
Nevada$38$108763,480-2.3%
West Virginia$38$9123246-2.9%
Utah$37$10756687-3.3%
Missouri$37$100841,724-4.2%
Oregon$37$129937,308-4.4%
Maryland$37$831296,759-4.6%
North Carolina$37$1121883,534-4.7%
Maine$37$15327178-5.1%
South Carolina$37$107782,229-5.4%
Virginia$37$1381873,138-5.6%
Mississippi$36$11743405-5.9%
Kansas$36$135441,123-6.9%
Kentucky$36$12753811-6.9%
Arkansas$36$10436977-7.2%
Montana$36$8531454-7.5%
Alabama$35$7332844-8.9%
Michigan$35$1312383,435-9.8%
South Dakota$35$7626399-9.8%
Oklahoma$35$86481,181-9.9%
Arizona$35$1181263,904-10.7%
Tennessee$34$1461207,283-11.5%
Ohio$34$941652,662-12.4%
Iowa$34$130651,219-13.0%
Louisiana$34$104331,479-13.0%
Wisconsin$32$1851261,523-17.3%
North Dakota$25$5223259-35.9%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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💊 Need post-procedure medications? Check costs on OpenPrescriber