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96020 Functional brain mapping

What 96020 is

CMS fee schedule short descriptor: Functional brain mapping.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 96020 (CY2026)

This code has no Physician Fee Schedule rate: Carrier-priced - the Medicare contractor sets the price. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.

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Medically Unlikely Edit (MUE)

Medicare caps 96020 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 96020? These codes are bundled into it

96020 is a Column 1 code in 77 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
0333TVisual ep scr acuity auto1 - modifier may bypassCheck pair
0464TVisual ep test for glaucoma1 - modifier may bypassCheck pair
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
92558Evoked auditory test qual1 - modifier may bypassCheck pair
92587Evoked auditory test limited1 - modifier may bypassCheck pair
92588Evoked auditory tst complete1 - modifier may bypassCheck pair
92650Aep scr auditory potential1 - modifier may bypassCheck pair
92651Aep hearing status deter i&r1 - modifier may bypassCheck pair
92652Aep thrshld est mlt freq i&r1 - modifier may bypassCheck pair
92653Aep neurodiagnostic i&r1 - modifier may bypassCheck pair
95812Eeg 41-60 minutes1 - modifier may bypassCheck pair
95813Eeg extnd mntr 61-119 min1 - modifier may bypassCheck pair
95816Eeg awake and drowsy1 - modifier may bypassCheck pair
95819Eeg awake and asleep1 - modifier may bypassCheck pair
95829Surgery electrocorticogram1 - modifier may bypassCheck pair
95851Range of motion measurements1 - modifier may bypassCheck pair
95852Range of motion measurements1 - modifier may bypassCheck pair
95860Needle emg 1 extremity1 - modifier may bypassCheck pair
95861Needle emg 2 extremities1 - modifier may bypassCheck pair
95863Needle emg 3 extremities1 - modifier may bypassCheck pair
95864Needle emg 4 extremities1 - modifier may bypassCheck pair
95865Needle emg larynx1 - modifier may bypassCheck pair
95866Needle emg hemidiaphragm1 - modifier may bypassCheck pair
95867Ndl emg cranial nrv musc uni1 - modifier may bypassCheck pair
95868Ndl emg cranial nrv musc bi1 - modifier may bypassCheck pair
95869Ndl emg thrc paraspinal musc1 - modifier may bypassCheck pair
95870Ndl emg lmtd std musc 1 xtr1 - modifier may bypassCheck pair
95907Nvr cndj tst 1-2 studies1 - modifier may bypassCheck pair
95908Nrv cndj tst 3-4 studies1 - modifier may bypassCheck pair

Showing 30 of 77 column 2 codes. Use the pair checker for any specific combination.

96020 is bundled into these codes

96020 appears as a Column 2 code in 89 active edits. Reported with one of these Column 1 codes on the same date of service, 96020 is the code that denies.

Column 1 codeShort descriptionModifier indicator
70554Fmri brain by tech1Check pair
99202Office o/p new sf 15 min1Check pair
99203Office o/p new low 30 min1Check pair
99204Office o/p new mod 45 min1Check pair
99205Office o/p new hi 60 min1Check pair
99211Off/op est may x req phy/qhp1Check pair
99212Office o/p est sf 10 min1Check pair
99213Office o/p est low 20 min1Check pair
99214Office o/p est mod 30 min1Check pair
99215Office o/p est hi 40 min1Check pair
992211st hosp ip/obs sf/low 401Check pair
992221st hosp ip/obs moderate 551Check pair
992231st hosp ip/obs high 751Check pair
99231Sbsq hosp ip/obs sf/low 251Check pair
99232Sbsq hosp ip/obs moderate 351Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.