CPT code 96113: Developmental testing, each additional 30 minutes2026 Medicare rate & RVUs in South Carolina

In South Carolina, Medicare pays $54.72 for 96113 in the office and $44.53 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 96113 nationwide

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

What 96113 covers

A physician or other qualified health care professional uses this service for additional time administering and evaluating standardized developmental tests. Testing may assess a child’s language, motor, cognitive, social, memory, or adaptive functioning when developmental delay or another developmental concern prompts a formal evaluation. It can occur in an office, clinic, or other setting where the clinician performs the assessment with the patient and, when relevant, family members.

Report 96113 only with 96112, the primary developmental-testing service, for qualifying time beyond its initial hour. The record should identify the testing performed, the functions assessed, total service time, and the scoring, interpretation, and report supporting the additional work. CMS classifies 96113 as an add-on code: it cannot be billed alone, and payment is within the primary service’s global-period context.

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.

How South Carolina compares for 96113

Across 109 of 109 payment localities, the office rate for 96113 runs from $53.32 in Arkansas to $76.10 in Alaska. South Carolina pays $54.72. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

96113 rates by state

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

See 96113 in every payment locality

How the 96113 rate is calculated

Each of 96113’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 96113

The CMS indicators that decide how 96113 is paid alongside other services.

Codes related to 96113

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

How 96113 has changed in South Carolina

Price 96113 for an earlier date of service

Where the South Carolina rate applies

South Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 475 cities and communities in South Carolina. Some span more than one payment area; confirm with the service ZIP.

• Abbeville
• Abney Crossroads
• Adams Run
• Aiken
• Alcolu
• Allendale
• Anderson
• Andrews

Browse all communities in South Carolina

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