The short answer: this is the testing most likely to be covered, because the question is medical rather than educational. Neuropsychological testing measures how a brain is actually functioning — attention, memory, processing speed, executive function — usually after something changed it: a head injury, a stroke, a seizure disorder, a suspected dementia, a chemotherapy course, long-term illness. Coverage criteria are written for exactly that. What gets denied is testing where "abnormalities of brain or emotional function are not suspected" or where the purpose is educational or vocational documentation.
What the criteria actually say
Medi-Cal's own manual is unusually plain about when neuropsychological testing is medically necessary: "when there are mild deficits on standard mental status testing or clinical interview, and a neuropsychological assessment is needed to establish the presence of abnormalities or distinguish them from changes that may occur with normal aging, or the expected progression of other disease processes," or when the data "can be combined with clinical, laboratory and neuroimaging data to assist in establishing a clinical diagnosis in neurological or systemic conditions known to affect CNS functioning."¹
That sentence is the template for your request. A referral that says "memory complaints, rule out early cognitive decline versus depression, results will guide treatment planning" fits the criteria. One that says "patient would like cognitive testing" does not.
The money, honestly
Nobody official publishes the retail price, in California or nationally. What is published is Medicare's, which is the benchmark to reason from — 2026, California, non-facility:²
| What is billed | Code | Roughly |
|---|---|---|
| First hour of neuropsychological evaluation work | 96132 | $124 |
| Each additional hour | 96133 | $99 |
| First 30 minutes of test administration | 96136 | $46 |
| Each additional 30 minutes | 96137 | $39 |
| Same administration, by a technician | 96138 / 96139 | slightly less, and no professional work value at all |
A full battery is commonly six to eight hours of combined evaluation and administration, which is roughly $500–800 of Medicare money — and Medicare covers 80% of it after the Part B deductible, leaving the patient 20%.² Cash and commercial rates run substantially higher; a $2,500–6,000 quote is a real market number, not necessarily a fair one, and the way to test it is to ask how many hours under which codes.
Two rules that catch people. Medicare documentation guidance expects justification when testing exceeds eight hours. And Medi-Cal caps testing without prior authorisation at three hours of evaluation and five hours of administration a year, counted across every provider — a full neuropsychological battery needs the authorisation, so make sure it is requested before the appointment, not after.³
How to ask so it goes through
Say to the referring doctor: "Please include in the referral what changed, when, what has been ruled out, and what decision the results will inform." The criteria reward a differential question and reject a general one.
Say to the plan: "I'm requesting prior authorisation for CPT 96132, 96133, 96136 and 96137. What documentation do you need, and how many hours will you authorise?" Get a reference number, and get the hours in writing — an authorisation for four hours against an eight-hour battery is how a covered test becomes a surprise bill.
Do this: confirm the authorised hours before the appointment and ask the practice to confirm they will bill within them. If it is denied, the appeal is free and works about a third of the time → · What testing costs here →
Sources
- Medi-Cal Provider Manual, Non-Specialty Mental Health Services — medical-necessity criteria for neuropsychological testing — medi-cal.ca.gov.
- Computed from the CMS Physician Fee Schedule relative value file RVU26C with the 2026 geographic practice cost indices, non-facility, non-qualifying-APM conversion factor 33.4009 — cms.gov. Patient share of 20% after the Part B deductible per medicare.gov. Technician and automated codes carry a work RVU of 0.00 in the CMS file.
- Medi-Cal Provider Manual, NSMHS annual frequency limits: 96130/96132/96136 one per year, 96131/96133 two per year, 96137 nine per year, "any provider"; a treatment authorisation request is required to exceed them.
All figures checked 17 August 2026.