CPT 96121

Neurobehavioral Status Xm Phys/Qhp Ea Addl Hour

CPT 96121 pays $75.49 in a non-facility setting and $61.46 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $72.78 in Arkansas to $105.07 in Alaska, a 44% spread.

National non-facility rate

$75.49

Office and other outpatient settings

Facility rate
$61.46

Hospital and ASC settings

Highest state
$105.07

Alaska

Lowest state
$72.78

Arkansas · 44% 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 $75.49
CPT 96121 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $75.49, national facility $61.46.
StateRate compared visuallyNon-facilityFacility
Alaska
$105.07$90.13
District of Columbia
$81.82$65.29
New Jersey
$80.73$64.93
California
$80.69$64.09
New York
$80.40$64.75
Washington
$79.74$63.75
Massachusetts
$79.29$63.53
Connecticut
$78.09$62.98
Hawaii
$77.82$61.87
Colorado
$77.25$62.33
Rhode Island
$77.13$62.64
Maryland
$77.02$62.40
Oregon
$76.82$62.04
New Hampshire
$76.18$61.58
Florida
$75.86$61.79
Minnesota
$75.77$61.34
Puerto Rico
$75.68$61.50
Virgin Islands
$75.68$61.50
Pennsylvania
$75.65$61.91
Delaware
$75.52$61.66
Texas
$75.50$61.69
Montana
$75.49$61.46
Nevada
$75.45$61.41
Wyoming
$75.40$61.37
Illinois
$75.38$61.83
North Dakota
$75.29$61.26
South Dakota
$75.26$61.24
Vermont
$75.14$61.25
Virginia
$75.08$61.29
Arizona
$74.88$61.29
Georgia
$74.81$61.42
Maine
$74.56$61.15
Michigan
$74.52$61.35
Wisconsin
$74.50$61.06
Utah
$74.37$61.18
North Carolina
$74.16$61.07
South Carolina
$74.07$61.10
New Mexico
$74.06$61.19
Indiana
$74.00$60.99
Missouri
$74.00$61.12
Louisiana
$73.93$61.12
Ohio
$73.92$61.11
Nebraska
$73.89$60.94
Idaho
$73.87$60.96
Iowa
$73.75$60.92
Tennessee
$73.69$60.94
Kansas
$73.59$60.91
Oklahoma
$73.48$60.95
Kentucky
$73.46$60.98
West Virginia
$73.27$61.08
Alabama
$73.09$60.81
Mississippi
$72.89$60.81
Arkansas
$72.78$60.73

Commercial rates for 96121

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

See negotiated rates