What this guide is best for
Direct answer: Use this guide once you know you are on the private route and a practice has told you, or can tell you, how many hours it expects.
Best used when: The bill is hours under four separate codes, so an estimate without an hours figure is not an estimate at all.
Estimating what an evaluation will cost
Key point: The bill is hours under four separate codes, so an estimate without an hours figure is not an estimate at all.
What a good provider should make clear: A good provider should put the planned units of each code in writing and say what happens to the fee if testing runs long.
Common mistake: Comparing two practices on their headline totals when one is planning six hours of testing and the other eleven.
Questions to ask: Ask how many hours of 96132 and 96133 and how many units of 96136 and 96137 are planned, and whether a facility will bill separately.
Estimating what an evaluation will cost
Opening intent: show the published per-hour figures and the hours variable that decides the bill, instead of quoting a total nobody can quote
| Cost question | What matters |
|---|---|
| What are you really comparing? | Use this guide once you know you are on the private route and a practice has told you, or can tell you, how many hours it expects. |
| What changes total cost? | The bill is hours under four separate codes, so an estimate without an hours figure is not an estimate at all. |
| Where people get burned | Comparing two practices on their headline totals when one is planning six hours of testing and the other eleven. |
| What to ask before paying | Ask how many hours of 96132 and 96133 and how many units of 96136 and 96137 are planned, and whether a facility will bill separately. |
What an evaluation costs, worked out in the open
Nobody can tell you the price of a neuropsychological evaluation, because it is not priced as one thing. It is billed as hours, under four codes, and the number of hours is decided after somebody has met you.
So this page does not quote a price. It gives you the published per-hour figures, lets you put your own hours against them, and shows the arithmetic. If a clinic will tell you how many hours it plans, you can do this before you book.
Two routes skip the arithmetic entirely. A public school district evaluation under IDEA is provided at no cost to parents, and a consultative examination that the Social Security Administration orders is paid for by SSA. Settle which route you are on first — the three routes are compared here — and only then estimate.
The four codes, and what was billed under each
National Medicare figures for calendar year 2024, office (non-facility) setting. The submitted charge is what clinicians billed; the allowed amount is what Medicare permitted, including the patient's coinsurance.
| Code | Unit | Avg submitted charge | Avg Medicare allowed |
|---|---|---|---|
| 96132 | Evaluation, first hour | $317.32 | $124.09 |
| 96133 | Evaluation, each additional hour | $278.83 | $95.38 |
| 96136 | Test administration, first 30 minutes | $128.16 | $39.87 |
| 96137 | Test administration, each additional 30 minutes | $125.20 | $36.83 |
Notice that the evaluation codes and the administration codes are separate. Time spent sitting with the tests and time spent interpreting them are billed apart, which is why "how much is the testing?" and "how much is the evaluation?" can get two different answers from the same honest person.
Estimator
Enter the hours a clinic tells you it expects. Nothing here is sent anywhere; the arithmetic happens in your browser.
If the boxes above are not working, the sum is simple enough to do on paper: one first hour, plus one additional hour for every hour after that, plus one first half-hour of administration, plus one additional half-hour for each one after that.
Why this is not a quote, and what would make it one
Source: Centers for Medicare & Medicaid Services, Medicare Physician & Other Practitioners — by Geography and Service, calendar year 2024 claims. National rows, office place of service, printed unchanged. Nothing on this page is modelled or adjusted.
- These are Medicare fee-for-service claims. The patients behind them skew 65 and older and disabled beneficiaries. If you are a parent arranging a child's evaluation, this is a different population from yours.
- The submitted charge is list price. Almost nobody pays it. The allowed amount is one payer's negotiated price. Your plan will allow a different number.
- Hours are the variable this page cannot supply. A clinic that will not estimate hours has not given you a price, whatever total it names.
- A hospital outpatient department bills a separate facility charge that is not in this dataset and is not in this estimate.
- Intake, records review, school observation and follow-up correspondence may bill under other codes or not at all, depending on the practice.
What turns this into a quote is a written estimate from a named practice that lists the codes, the planned units of each, and what happens to the fee if testing runs long. Ask for that document. This page exists so you can read it critically when it arrives.
Ask these before you accept a number
- How many hours of 96132/96133 and how many units of 96136/96137 do you expect for my question?
- What is billed if testing runs past that estimate, and who decides?
- Is the feedback session, and the written report itself, inside the quoted fee?
- Will there be a second bill from a facility?
- If my plan denies the testing after it is done, what do I owe?
Common mistake: comparing two practices on their headline totals when one is quoting six hours and the other is quoting eleven.
What to do next
Get the planned hours in writing from two practices, run both through the same arithmetic, and compare the hours before you compare the totals. If one route is a school district evaluation or an SSA-ordered examination, price nothing until that is settled.
Educational only. Not medical advice, and not a price quote. No endorsements or rankings.