96138

Administration of psychological or neuropsychological test by technician, first 30 minutes

Medicare pricing data for 4,542 providers across 51 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 by technician, first 30 minutes (HCPCS code 96138) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $32.00, but hospitals typically charge $104.54 — a 3.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$6.40

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $32.00, your out-of-pocket cost would be approximately $6.40. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$32.00
Average Hospital Charge
$104.54
Markup Ratio
3.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$104.54
Medicare Allowed$32.00
Medicare Payment$24.73

Hospitals charge 3.3x more than what Medicare allows for this procedure. Medicare actually pays $24.73 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$40$1162398,741+25.4%
Washington$39$104383,858+21.9%
California$39$9541525,156+21.2%
District of Columbia$39$9210315+20.6%
New Jersey$38$991563,874+19.6%
Hawaii$37$7411242+16.5%
Massachusetts$37$124963,229+15.8%
Alaska$36$12315412+13.0%
Maryland$36$1821103,925+12.1%
Colorado$35$117691,703+10.4%
Rhode Island$35$10220190+9.7%
Virginia$35$1131164,058+9.1%
Oregon$35$81361,399+8.5%
Connecticut$34$11248628+7.3%
Illinois$34$1321513,586+7.2%
Minnesota$34$148912,389+6.7%
North Dakota$34$64301,012+5.5%
New Hampshire$34$10115509+5.3%
Montana$34$7317382+5.2%
South Dakota$34$537196+5.0%
Vermont$33$10910720+4.2%
Delaware$33$119358,368+4.0%
Wyoming$33$1645512+3.7%
Pennsylvania$33$12817310,146+2.8%
Florida$32$10634916,917+0.6%
Wisconsin$32$225892,430+0.5%
Nevada$32$139642,666+0.4%
Arizona$32$1001145,850+0.3%
Georgia$32$1022096,386-0.6%
Michigan$32$831472,662-0.7%
Maine$31$8518196-1.6%
Missouri$31$128813,880-2.1%
North Carolina$31$1061154,060-3.5%
Ohio$31$911142,757-3.7%
Kansas$31$13818950-4.3%
Iowa$30$12322723-5.3%
Utah$30$8038933-5.3%
Nebraska$30$12229813-5.5%
South Carolina$30$133541,359-5.6%
Indiana$30$84832,200-5.9%
New Mexico$30$7720580-6.6%
Louisiana$30$77561,137-7.2%
Alabama$30$57511,787-7.8%
Kentucky$29$72251,016-8.6%
Oklahoma$29$81643,247-8.7%
West Virginia$29$9018542-9.8%
Mississippi$28$10519814-11.0%
Arkansas$28$74362,274-11.7%
Tennessee$27$801458,361-14.8%
Idaho$26$7921215-17.2%
Texas$21$8360727,579-33.7%

⚠️ 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