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CPT code 96110: Developmental screening, per standardized instrument2026 Medicare rate & RVUs

Reports a brief standardized developmental screen with scoring and documentation to identify possible concerns during a child’s care.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · 96110

Developmental screening, per standardized instrument

Office or facility?

Work RVUs
0
Total RVUs
0.37
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for 96110 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 96110 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 96110 covers

96110 covers a brief standardized developmental screen used to identify possible developmental concerns, rather than an in-depth developmental test. In pediatric primary care and preventive visits, a clinician or office staff member may administer a tool to a child or have a caregiver complete it; the practice scores the instrument and records the result. General developmental questionnaires and autism screening tools, including M-CHAT, are examples.

Report the service by standardized instrument, not elapsed time; each completed, scored, and documented instrument represents a unit. The record should identify the tool and its result. Medicare assigns 96110 status N, meaning the service is not covered by Medicare. It is distinct from developmental testing reported under 96112 and brief emotional or behavioral assessment reported under 96127.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 96110 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

96110 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

96110 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
96110 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 96110 rate is calculated

Each of 96110’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 96110

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.36

0.36 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

0.3700

Conversion factor

$33.4009

Medicare rate

$12.36

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 96110

96110 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · 96110

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

96110 isn’t priced in this setting.

96110 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 96110

    Developmental screening, per standardized instrument0 wRVU

    Not priced

  • 96112

    Developmental testing, initial hour2.56 wRVU

    $125.25

  • 96127

    Behavioral screening tool, per scored standardized instrument0 wRVU

    $5.01

  • 96160

    Health risk assessment, patient-focused instrument0 wRVU

    $3.01

How to choose

96112Developmental testingInitial hour
Use 96110 for a brief standardized developmental screen. 96112 describes developmental testing reported by time.
96127Behavioral screening toolPer scored standardized instrument
96127 is for a brief emotional or behavioral assessment; 96110 is for developmental screening.
96160Health risk assessmentPatient-focused instrument
96160 describes a patient-focused health risk assessment, rather than a standardized developmental screen.

Codes related to 96110

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 96110
CodeHow it relatesNational office range
Often billed with
99381Infant preventive visit, new patient, under 1 yearInitial preventive visit for an infant; developmental screening may occur during the same encounter.No office rate
99391Infant preventive visit, established patientEstablished-patient preventive visit for an infant; developmental screening may occur during the same encounter.No office rate
99392Well-child visit, established, age 1–4Established-patient preventive visit for a young child; developmental screening may occur during the same encounter.No office rate

96110 billing questions

Is 96110 billed per instrument or per hour?

It is reported per standardized instrument that is completed, scored, and documented. The unit is not time-based.

How is 96110 different from 96112?

96110 describes a brief standardized developmental screen. 96112 is for developmental testing, a more extensive service reported by time.

Can 96110 be performed during a preventive visit?

A developmental screen may be performed during a child’s preventive visit. The screening and preventive visit describe distinct services.

What documentation supports 96110?

Record the standardized instrument used, that it was completed, and its score or result.

Does Medicare cover 96110?

No. Medicare assigns 96110 status N, meaning it is not covered.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates

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