BCBSTX Psychological Testing Reimbursement Rates in Texas (2026)

Blue Cross and Blue Shield of Texas pays psychologists a median of $104.70 for the first hour of a testing evaluation. What you are actually paid depends heavily on which BCBSTX plan the patient has.

The rates come from BCBSTX’s own Texas networks for August 2026. Those are Blue Choice PPO, Blue Essentials, Blue Advantage HMO, Blue Premier, MyBlue Health HMO, and the traditional ParPlan network.

We read all seven network files, 38 gigabytes of data. We kept dollar rates for professional claims and left out $0.00 placeholders, percent-of-charge contracts, and reduced or discontinued services (modifiers 52 and 53). We then kept psychologists and neuropsychologists whose practice address in the federal NPPES registry is in Texas. Most psychologists have several rates for the same code, roughly one per network, and the table counts each different rate once.

What Does BCBSTX Pay for Psychological Testing in Texas?

The median BCBSTX rate for 96130 is $104.70, across 3,229 Texas psychologists and neuropsychologists.

CPT Code	Description	Mean Negotiated Rate	Median Negotiated Rate	Min	Max	Unique NPI Count
96130	Psychological testing evaluation, first hour	$106.27	$104.70	$60.48	$279.97	3,229
96131	Psychological testing evaluation, each additional hour	$74.85	$73.73	$41.31	$212.95	3,229
96132	Neuropsychological testing evaluation, first hour	$108.97	$105.07	$58.64	$314.76	3,226
96133	Neuropsychological testing evaluation, each additional hour	$80.05	$74.81	$41.49	$240.10	3,223
96136	Test administration by a professional, first 30 minutes	$30.67	$29.03	$12.91	$112.84	3,226
96137	Test administration by a professional, each additional 30 minutes	$25.91	$25.57	$9.77	$104.35	3,229
96138	Test administration by a technician, first 30 minutes	$32.56	$31.27	$19.18	$91.63	3,226
96139	Test administration by a technician, each additional 30 minutes	$32.57	$31.27	$19.18	$91.63	3,223

Rates extracted from BCBSTX’s August 2026 Texas machine readable files.

The first hour of a neuropsychological evaluation (96132) pays almost the same, at $105.07. 96130 rates run from $60.48 to $279.97, and the plan type explains much of that spread.

Giving the tests is billed in 30-minute units. When the psychologist gives them, the median is $29.03 for the first 30 minutes (96136) and $25.57 for each 30 minutes after (96137). When a technician gives them, 96138 and 96139 both have a median of $31.27. A technician’s half hour pays slightly more than the psychologist’s, not less.

Do BCBSTX HMO Plans Pay Less for Testing?

Yes. For the same psychologist, the two HMO plans pay about $22 less per hour of testing evaluation than Blue Choice PPO.

The 96130 median is $86.32 on both Blue Advantage HMO and MyBlue Health HMO, against $109.06 on Blue Choice PPO. Blue Essentials, Blue Premier, and ParPlan sit close to the PPO. We looked at the 2,175 psychologists who have a 96130 rate on both Blue Choice PPO and Blue Advantage HMO. The HMO paid 95 percent of them less, by a median of $21.73. Technician time follows the same pattern, at $25.02 per half hour on the two HMOs and $31.30 on Blue Choice PPO.

What Do the First Two Hours of an Evaluation Pay?

At the medians, one hour of evaluation plus one hour of the psychologist giving tests pays $159.30.

That is one 96130, one 96136, and one 96137. BCBSTX’s coding policy expects 3 to 4 hours for an uncomplicated ADHD evaluation and 8 hours for a neuropsychological evaluation, so a full evaluation adds more units on top.

Does BCBSTX Require Prior Authorization for Testing?

Sometimes. BCBSTX says it will tell the practice when a testing case needs it.

The behavioral health provider manual lists psychological and neuropsychological testing among services that need prior authorization in some cases. BCBSTX can also require it after an audit if a practice’s hours or medical necessity fall outside the payer’s standards. Routine outpatient therapy is not on that list. The coding rules that do apply to every testing claim are in CPCP008, effective March 2, 2026.

• Base codes 96130, 96132, 96136, and 96138 may be used once per testing episode, even when testing spans several days.
• Do not bill both a psychological evaluation (96130) and a neuropsychological evaluation (96132) for the same episode. Pick the one that matches the referral question.
• A 30-minute administration code needs at least 16 minutes. An hourly evaluation code needs at least 31 minutes.
• More than one testing claim in a calendar year can be pulled for records and a medical necessity review.
• Submit the claim when the whole episode is done, including scoring, the report, and feedback.

Who Can Bill Testing Evaluation Codes in Texas?

The psychologist who interprets the tests bills 96130 through 96133.

CPCP008 limits those codes to a qualified professional who is independently licensed in Texas to do the evaluation. People working or training under that psychologist are technicians for this policy, and their time bills as 96138 and 96139. The interpretation still bills under the licensed psychologist.

How Do Texas Medicaid Testing Rates Compare?

Texas Medicaid pays a psychologist $88.21 for an adult’s 96130. That is below BCBSTX’s overall median but above the $86.32 its two HMO plans pay.

Medicaid also pays more for the psychologist’s time giving tests, at $33.68 for 96136 against BCBSTX’s median of $29.03. Both are office rates from the TMHP psychologist fee schedule dated July 29, 2026, which we checked on September 29, 2026. The 96130 fee has not changed since January 1, 2019. For therapy codes, see our BCBSTX behavioral health rates in Texas.

What Do Texas Practices Charge for a Self-Pay Evaluation?

Two Texas neuropsychology practices that publish their fees charge from $975 to $4,900 for an evaluation. A Houston practice says in-person testing usually takes 2 to 4 hours and usually costs $975 to $4,900. A Central Texas practice lists a focused evaluation with 2 to 3 hours of testing and a report starting at $1,250, and a comprehensive evaluation starting at $2,100. We checked both fee pages on September 29, 2026. These are prices for a finished evaluation, and even the lowest is far above the $159.30 BCBSTX pays at the median for the first two hours.

What This Means for Your Practice

Compare your own BCBSTX rates with these medians to see whether your contract is fair. Check each plan separately, since the HMO plans pay less.

If your rates are low, the medians and the Texas Medicaid figures give you concrete numbers to bring to a rate request. Our guide to negotiating insurance contract rates covers how to make the ask.

Once good rates are in place, Fuse helps make sure you actually get paid them. We check claims against your contracted rates and confirm each patient’s coverage before the testing day. Reach out if you’d like to chat.

Disclaimer: This article uses rate information from the Machine Readable Files that Blue Cross and Blue Shield of Texas publishes under the federal Transparency in Coverage rule. These files are posted to satisfy the regulation, not to be read. The files behind this analysis unpack to 38 gigabytes of raw pricing data that no spreadsheet can open. Fuse built its own software to extract and verify the figures above. This analysis focuses on a single payer and will not reflect rates from all available insurance options in Texas. Fuse makes every effort to provide accurate and current information, but healthcare pricing and coverage policy change frequently, and individual circumstances affect actual payment. This information does not guarantee specific pricing. Practices should verify current rates directly with BCBSTX before relying on them for billing or negotiation decisions.