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

CMS doesn’t publish an office rate for 96110 in Texas.

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

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 in Texas

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

8 of 8 payment localities

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.

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.

96110 compared with similar codes

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.

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