What this guide is best for
Direct answer: Use this before you accept a package price for testing you have not seen itemised.
Best used when: An evaluation is billed in hours across several codes, so the total depends on how many hours are planned.
Pricing an evaluation by its parts
Key point: An evaluation is billed in hours across several codes, so the total depends on how many hours are planned.
What a good provider should make clear: A written estimate showing the codes, the planned hours per code, and the price per hour.
Common mistake: Comparing two package prices without asking how many testing hours each one covers.
Questions to ask: How many hours of each code do you expect to bill, and what is your rate per hour?
Pricing an evaluation by its parts
Opening intent: break the evaluation into the billing codes it is actually made of, then price each one
| Cost question | What matters |
|---|---|
| What are you really comparing? | Use this before you accept a package price for testing you have not seen itemised. |
| What changes total cost? | An evaluation is billed in hours across several codes, so the total depends on how many hours are planned. |
| Where people get burned | Comparing two package prices without asking how many testing hours each one covers. |
| What to ask before paying | How many hours of each code do you expect to bill, and what is your rate per hour? |
Quick answer
A neuropsychological evaluation is not one price. It is a stack of hourly billing codes, and the total depends almost entirely on how many hours get planned.
Ask for the codes and the hours. A package price without them tells you nothing you can compare.
The published price of each code
National figures, office setting, calendar year 2024 Medicare claims.
| Code | What it covers | Average submitted charge (office) | Average Medicare allowed |
|---|---|---|---|
| 96116 | Neurobehavioral status exam, first hour | $252.62 | $90.56 |
| 96130 | Psychological testing evaluation, first hour | $288.14 | $114.01 |
| 96132 | Neuropsychological testing evaluation, first hour | $317.32 | $124.09 |
| 96133 | Neuropsychological testing evaluation, each extra hour | $278.83 | $95.38 |
| 96136 | Test administration, first 30 minutes | $128.16 | $39.87 |
| 96137 | Test administration, each extra 30 minutes | $125.20 | $36.83 |
The first evaluation hour was billed at $317.32 and allowed at $124.09. Each further hour was allowed at $95.38.
Test administration is cheaper per unit and often the largest block of time: $39.87 allowed for the first half hour, $36.83 for each additional half hour.
So a six-hour evaluation is not six times the headline. Work out the mix before you compare quotes.
What is not published, and why
No authority publishes a self-pay price for neuropsychological testing. The Medicare allowed amount is what one payer permits, not a market rate.
The submitted charge is closer to a self-pay starting point. It is still a list price, and list prices are negotiable more often than people assume.
Practices that do not take insurance set their own rates, and those rates appear in no dataset. Ask directly.
How the hours get spent
Intake and history. Test administration, usually the longest block. Scoring. Interpretation and report writing. A feedback session.
Report writing is billed under the evaluation codes, not the administration codes, which is why the mix matters so much to the total.
Questions to ask before booking
- How many hours do you expect to bill under 96132 and 96133?
- How many half-hour units of 96136 and 96137 are planned?
- Is the feedback session included, or billed separately?
- What is your self-pay rate, and does it differ from the billed charge?
- What happens to the price if testing runs long?
Common mistake: assuming a package price caps the hours. Confirm in writing that it does.
Where these numbers come from, and what they are not
Source: Centers for Medicare & Medicaid Services, Medicare Physician & Other Practitioners — by Geography and Service, calendar year 2024 claims (file released 21 May 2026).
Method: we pull the published rows for each billing code, keep the average submitted charge and the average Medicare allowed amount, and print them unchanged. Nothing is modelled, averaged across codes, or adjusted.
- The submitted charge is what clinicians billed. It is list price. Almost nobody pays it.
- The allowed amount is what Medicare permitted, including the patient's coinsurance. It is a negotiated price.
- These are Medicare fee-for-service claims. The patients skew 65 and older.
- If you are paying cash or using commercial insurance, neither figure is your price. Use the gap between them as a bargaining range, not a quote.
- CMS hides any cell covering fewer than 11 patients, so some states are missing. We print "not published" there rather than guessing.
Common mistake: reading the allowed amount as "the real price" and expecting a clinic to match it. It is what one payer pays one set of clinicians.
What to do next
Ask two practices for an estimate broken out by code and hour. Compare the hours first, then the rates.
Educational only. Not medical advice. No endorsements or rankings.