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CPT code

96116: Neurobehavioral status exam, first hour

96116 is the clinical interview and assessment of higher cortical functions: attention, memory, language, executive function, and behavior, done by the psychologist face to face. In an ADHD or autism evaluation it is the structured clinical assessment that sits next to test administration and scoring.

Kind
CPT code
Family
testing
Time
First 60 minutes; 96121 for each additional hour
Who bills
Psychologists
Telehealth
Eligible
Add-on
Stands alone

When to use it

Use it for the clinician's own neurobehavioral status exam time, first hour, with 96121 for each additional hour, when it is a distinct service from test administration and evaluation.

When not to

Do not use it for the time spent administering standardized tests (96136 to 96139) or for integrating results and writing the report (96130 and 96131).

With children and families

With children the exam blends observation, parent report, and direct tasks. Record the domains assessed and the age-appropriate methods. When the exam is delivered by video, note how you adapted tasks and what the parent set up in the room.

Questions about 96116

Is 96116 part of every ADHD evaluation?
Not always. It is billed when a distinct neurobehavioral status exam is performed and documented.
Can 96116 be delivered by telehealth?
Yes, when the payer allows telehealth testing and the tasks can be validly delivered on video.

Related

CodeWhat it isTimeWho billsTelehealth
96130Psychological testing evaluation services, first hourFirst 60 minutes; 96131 for each additional hourPsychologistsYes
96136Test administration and scoring by psychologist, first 30 minutesFirst 30 minutes; 96137 for each additional 30 minutesPsychologistsYes

General information for licensed clinicians, not billing advice. Insurers reimburse each code differently and payer contracts control; Emora handles the billing.

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