LCD L34353: Outpatient Psychiatry and Psychology Services — CGS Administrators
Outpatient · LCD-L34353
Government source· CMS / MACverify ↗Full analysis available with a CLV subscription.
View alertCPT procedure code
96130
Medicare payment
$123.92
2026 Physician Fee Schedule · non-facility
Source: CMS Physician Fee Schedule (PPRRVU 2026). CMS fee schedules ↗ · PFS status indicator A
National amount before geographic adjustment. Your MAC's locality rate will differ.
Code definition
Code
96130
Code system
CPT (Current Procedural Terminology)
This CPT code is not in our curated reference. CPT codes are maintained by the American Medical Association (AMA). Full descriptions require an AMA license.
Category
—
Short description sourced from CMS publicly available fee schedule data. Full CPT descriptions are copyright AMA. Not a substitute for the official CPT codebook.
Policy activity for CPT 96130
CLV Intelligence is tracking 3 policy changes that cite CPT 96130 between 2026-06-05 and 2026-07-23, drawn from 2 LCD/NCD coverage updates and 1 MAC LCD revision. The changes span Multi-specialty, Outpatient and Psychiatry. 1 is flagged critical or high priority.
- LCD/NCD coverage updates
- 2
- MAC LCD revision
- 1
Counts reflect the source documents CLV has matched to CPT 96130 to date; each links to the government publication that is authoritative. Monitored daily from CMS, the Federal Register, and Medicare Administrative Contractor publications.
Policy changes matched to 96130
Matched to this code by CLV analysis of each policy. The linked source document is authoritative.
High
LCD L34196: Psychiatric Partial Hospitalization Programs — CGS
Psychiatry · LCD-L34196
Government source· CMS / MACverify ↗Full analysis available with a CLV subscription.
View alertLCD L33632: Psychiatry and Psychology Services — Wellpoint Federal
Multi-specialty · LCD-L33632
Government source· CMS / MACverify ↗Full analysis available with a CLV subscription.
View alertAudit documentation
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