CPT 96112

Developmental Tst Admin Phys/Qhp 1st Hour

CPT 96112 pays $125.25 in a non-facility setting and $106.88 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $118.04 in Arkansas to $168.19 in Alaska, a 42% spread.

National non-facility rate

$125.25

Office and other outpatient settings

Facility rate
$106.88

Hospital and ASC settings

Highest state
$168.19

Alaska

Lowest state
$118.04

Arkansas · 42% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $125.25
CPT 96112 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $125.25, national facility $106.88.
StateRate compared visuallyNon-facilityFacility
Alaska
$168.19$148.62
District of Columbia
$136.64$115.00
New York
$135.04$114.55
New Jersey
$134.46$113.78
California
$132.60$110.87
Washington
$131.87$110.93
Massachusetts
$131.29$110.65
Connecticut
$130.65$110.86
Florida
$129.80$111.37
Illinois
$128.63$110.88
Maryland
$128.22$109.07
Hawaii
$128.09$107.20
Rhode Island
$127.53$108.55
Colorado
$127.50$107.95
Oregon
$126.52$107.17
New Hampshire
$126.11$106.98
Pennsylvania
$125.63$107.63
Puerto Rico
$125.57$107.00
Virgin Islands
$125.57$107.00
Montana
$125.24$106.87
Michigan
$125.02$107.77
Texas
$124.85$106.76
Delaware
$124.79$106.64
Georgia
$124.69$107.16
Nevada
$124.51$106.12
Wyoming
$124.04$105.67
Arizona
$123.49$105.69
New Mexico
$123.28$106.44
Virginia
$123.28$105.22
Minnesota
$122.98$104.08
Utah
$122.67$105.40
West Virginia
$122.67$106.71
Vermont
$122.59$104.41
North Dakota
$122.48$104.11
Louisiana
$122.42$105.65
Missouri
$122.29$105.43
Ohio
$122.24$105.47
South Dakota
$122.15$103.78
Maine
$121.95$104.39
South Carolina
$121.89$104.91
North Carolina
$121.22$104.08
Kentucky
$120.96$104.63
Wisconsin
$120.54$102.95
Oklahoma
$120.46$104.05
Indiana
$120.29$103.26
Idaho
$119.98$103.08
Tennessee
$119.90$103.20
Nebraska
$119.64$102.69
Kansas
$119.57$102.96
Iowa
$119.45$102.64
Mississippi
$119.16$103.34
Alabama
$118.84$102.77
Arkansas
$118.04$102.26

Commercial rates for 96112

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates