This reimbursement calculator provides estimate-only projections based on modeled 2026 Medicare allowed amounts, representative CPT coding scenarios, and user-selected variables. Results do not constitute financial, legal, coding, or regulatory advice and should not be interpreted as guaranteed reimbursement. Actual reimbursement may vary based on payer acceptance rates, geographic location, payer mix, provider type and scope, applicable modifiers, testing duration, personnel involved, and claim adjudication outcomes.
Creyos does not determine reimbursement eligibility and assumes no responsibility for claim payment decisions. Users are responsible for validating coding, coverage, and billing requirements with their applicable payers.
"Other" Blended Provider Selection
Represents a blended reimbursement estimate across common psychological and neuropsychological testing scenarios. Actual reimbursement varies by provider credentials, scope, CPT selection, testing time, and personnel involved.
Qualifying APM Status
Qualifying APM status does not change CPT-level reimbursement. If applicable, a separate 5% incentive is calculated on prior-year Medicare Part B allowed charges and paid as a lump sum. Eligibility and payment are determined by CMS and may vary by performance year.
