# CPT 96116: Neurobehavioral status exam, first hour

Medicare CPT 96116 pays $94.19 in a non-facility setting and $72.15 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $88.98 in Arkansas to $126.31 in Alaska, a 42% spread.

Web page: https://www.med-reveal.com/rates/96116-cpt-fee-schedule
Section: Behavioral Health
Billed by: Child & Adolescent Psychiatry, Clinical Neuropsychologist, Psychiatry & Neurology

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $94.19 |
| National facility | $72.15 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $126.31 | $102.83 |
| District of Columbia | $103.12 | $77.15 |
| New Jersey | $101.35 | $76.52 |
| New York | $101.33 | $76.74 |
| California | $101.01 | $74.92 |
| Washington | $99.93 | $74.81 |
| Massachusetts | $99.36 | $74.60 |
| Connecticut | $98.17 | $74.43 |
| Hawaii | $97.47 | $72.40 |
| Maryland | $96.43 | $73.45 |
| Colorado | $96.42 | $72.97 |
| Florida | $96.19 | $74.07 |
| Rhode Island | $96.15 | $73.37 |
| Oregon | $95.75 | $72.52 |
| Illinois | $95.22 | $73.92 |
| New Hampshire | $95.17 | $72.22 |
| Puerto Rico | $94.49 | $72.20 |
| Virgin Islands | $94.49 | $72.20 |
| Pennsylvania | $94.28 | $72.68 |
| Montana | $94.19 | $72.14 |
| Delaware | $93.94 | $72.16 |
| Texas | $93.92 | $72.22 |
| Nevada | $93.89 | $71.82 |
| Wyoming | $93.67 | $71.62 |
| Minnesota | $93.65 | $70.97 |
| Georgia | $93.30 | $72.26 |
| Michigan | $93.17 | $72.47 |
| Virginia | $93.09 | $71.42 |
| North Dakota | $93.00 | $70.96 |
| Arizona | $92.97 | $71.61 |
| Vermont | $92.90 | $71.08 |
| South Dakota | $92.86 | $70.82 |
| Utah | $92.18 | $71.46 |
| Maine | $92.11 | $71.04 |
| New Mexico | $92.10 | $71.88 |
| Missouri | $91.68 | $71.46 |
| Louisiana | $91.67 | $71.55 |
| South Carolina | $91.61 | $71.24 |
| Ohio | $91.59 | $71.46 |
| Wisconsin | $91.54 | $70.42 |
| North Carolina | $91.45 | $70.89 |
| West Virginia | $91.12 | $71.96 |
| Indiana | $90.97 | $70.53 |
| Idaho | $90.73 | $70.45 |
| Kentucky | $90.68 | $71.09 |
| Nebraska | $90.63 | $70.28 |
| Oklahoma | $90.53 | $70.84 |
| Tennessee | $90.53 | $70.49 |
| Iowa | $90.43 | $70.26 |
| Kansas | $90.31 | $70.38 |
| Alabama | $89.56 | $70.27 |
| Mississippi | $89.49 | $70.51 |
| Arkansas | $88.98 | $70.04 |

## Related codes

- 96121: Neurobehavioral status exam, each additional hour (add-on) — https://www.med-reveal.com/rates/96121-cpt-fee-schedule
- 96125: Standardized cognitive performance testing, with interpretation and report — https://www.med-reveal.com/rates/96125-cpt-fee-schedule
- 96132: Neuropsychological testing evaluation services, first hour — https://www.med-reveal.com/rates/96132-cpt-fee-schedule
- 96133: Neuropsychological testing evaluation services, each additional hour (add-on) — https://www.med-reveal.com/rates/96133-cpt-fee-schedule
- 96146: Psychological/neuropsychological test administration, automated result only — https://www.med-reveal.com/rates/96146-cpt-fee-schedule

Commercial negotiated rates for 96116 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules