96131
Psychological testing evaluation, each additional hour
Psychological testing evaluation, each additional hour is the #612 most-billed Medicaid procedure code, with $126.6M in payments across 750K claims from 2018–2024. The national median cost per claim is $133.38. Costs vary widely — the 90th percentile is $296.77 per claim, 2.2× the median.
Total Paid
$126.6M
0.01% of all spending
Total Claims
750K
Providers
1K
Avg Cost/Claim
$169
National Cost Distribution
How much do providers bill per claim for 96131? Based on 1K providers billing this code nationally.
Median
$133.38
Average
$164.86
Std Dev
$162.17
Max
$2,557.69
Percentile Distribution (Cost per Claim)
50% of providers bill between $74.07 and $211.70 per claim for this code.
90% bill between $44.43 and $296.77.
Top 1% bill above $660.00.
About This Procedure
HCPCS code 96131 (Psychological testing evaluation, each additional hour) was billed by 1K providers across 750K claims, totaling $126.6M in Medicaid payments from 2018–2024. This code was used for 582K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$133.38
Providers Billing
1K
National Spending
$126.6M
Avg/Median Ratio
1.24×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 96131
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1861528390 | $6.8M |
| 2 | Dcps - Public Schools Washington, DC · Local Education Agency (LEA) | $2.9M |
| 3 | 1396807350 | $2.8M |
| 4 | 1275877896 | $2.7M |
| 5 | 1881746733 | $2.5M |
| 6 | 1750507653 | $2.4M |
| 7 | Wasatch Behavioral Health Special Service District Provo, UT · Community/Behavioral Health | $2.0M |
| 8 | 1619553963 | $2.0M |
| 9 | 1730229410 | $2.0M |
| 10 | 1467899666 | $1.5M |
| 11 | 1689928186 | $1.4M |
| 12 | Children's Specialized Hospital New Brunswick, NJ · Pediatrics | $1.3M |
| 13 | Nystrom & Associates, Ltd New Brighton, MN · Marriage & Family Therapist | $1.2M |
| 14 | 1427448695 | $1.2M |
| 15 | 1720260417 | $1.2M |
| 16 | 1487916433 | $1.1M |
| 17 | Fraser Child And Family Center Minneapolis, MN · Clinic/Center, Mental Health (Including Community Mental Health Center) | $958K |
| 18 | 1902377864 | $947K |
| 19 | 1124465182 | $941K |
| 20 | 1487047007 | $935K |
Showing top 20 of 1K providers billing this code