96132 Nrpsyc tst eval phys/qhp 1st
What 96132 is
CMS fee schedule short descriptor: Nrpsyc tst eval phys/qhp 1st.
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 96132 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 2.56 | 1.03 | 0.07 | 3.66 | $122.25 |
| Facility (hospital, ASC) | 2.56 | 0.32 | 0.07 | 2.95 | $98.53 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.
Medically Unlikely Edit (MUE)
Medicare caps 96132 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 96132? These codes are bundled into it
96132 is a Column 1 code in 22 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 code | Short description | Modifier indicator | |
|---|---|---|---|
0362T | Bhv id suprt assmt ea 15 min | 0 - no modifier bypass | Check pair |
0373T | Adapt bhv tx ea 15 min | 0 - no modifier bypass | Check pair |
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
90785 | Psytx complex interactive | 0 - no modifier bypass | Check pair |
96110 | Developmental screen w/score | 1 - modifier may bypass | Check pair |
96113 | Devel tst phys/qhp ea addl | 0 - no modifier bypass | Check pair |
96125 | Cognitive test by hc pro | 1 - modifier may bypass | Check pair |
96127 | Brief emotional/behav assmt | 0 - no modifier bypass | Check pair |
96146 | Psycl/nrpsyc tst auto result | 1 - modifier may bypass | Check pair |
96160 | Pt-focused hlth risk assmt | 1 - modifier may bypass | Check pair |
96161 | Caregiver health risk assmt | 1 - modifier may bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
97151 | Bhv id assmt by phys/qhp | 0 - no modifier bypass | Check pair |
97152 | Bhv id suprt assmt by 1 tech | 0 - no modifier bypass | Check pair |
97153 | Adaptive behavior tx by tech | 0 - no modifier bypass | Check pair |
97154 | Grp adapt bhv tx by tech | 0 - no modifier bypass | Check pair |
97155 | Adapt behavior tx phys/qhp | 0 - no modifier bypass | Check pair |
97156 | Fam adapt bhv tx gdn phy/qhp | 0 - no modifier bypass | Check pair |
97157 | Mult fam adapt bhv tx gdn | 0 - no modifier bypass | Check pair |
97158 | Grp adapt bhv tx by phy/qhp | 0 - no modifier bypass | Check pair |
G0451 | Devlopment test interpt&rep | 1 - modifier may bypass | Check pair |
96132 is bundled into these codes
96132 appears as a Column 2 code in 91 active edits. Reported with one of these Column 1 codes on the same date of service, 96132 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
92521 | Evaluation of speech fluency | 1 | Check pair |
92522 | Evaluate speech production | 1 | Check pair |
92523 | Speech sound lang comprehen | 1 | Check pair |
92524 | Behavral qualit analys voice | 1 | Check pair |
96020 | Functional brain mapping | 0 | Check pair |
96112 | Devel tst phys/qhp 1st hr | 0 | Check pair |
96156 | Hlth bhv assmt/reassessment | 1 | Check pair |
96158 | Hlth bhv ivntj indiv 1st 30 | 1 | Check pair |
96159 | Hlth bhv ivntj indiv ea addl | 1 | Check pair |
97161 | Pt eval low complex 20 min | 1 | Check pair |
97162 | Pt eval mod complex 30 min | 1 | Check pair |
97163 | Pt eval high complex 45 min | 1 | Check pair |
97164 | Pt re-eval est plan care | 1 | Check pair |
97165 | Ot eval low complex 30 min | 1 | Check pair |
97166 | Ot eval mod complex 45 min | 1 | Check 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.