CMS RVU26D · Effective 2026-10-01
Office / nonfacility
$127.90
Base rate per service
Facility setting
$107.77
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Developmental assessment
Report 96112 for physician- or qualified health care professional-led developmental testing with interpretation and a report, covering the initial hour of service.
A physician or other qualified health care professional uses standardized developmental measures and clinical observation to assess areas such as motor skills, language, cognition, social functioning, memory, or executive function. The service is commonly performed in a pediatric, developmental, psychology, or rehabilitation setting when a child’s development needs a more complete evaluation than a brief screening can provide. The clinician interprets the results and prepares a report.
Report 96112 for the initial hour of qualifying developmental testing. Documentation should identify the assessment performed, the developmental domains evaluated, the clinician’s work, and the interpretation and report. When additional qualifying testing time is supported, report it with 96113, the add-on code for additional time. Medicare physician fee schedule valuation is available by setting; the submitted service and setting determine the applicable schedule amount.
13.7K
Medicare services in 2024 · #1309 by national volume
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.
Office rates for Modesto, from the same CMS release.
Developmental screen w/score
Choose 96110 for developmental screening with a score. Choose 96112 when a physician or qualified health care professional performs a fuller developmental testing service with interpretation and a report.
96112 represents the initial hour of developmental testing. 96113 is used for additional qualifying time and is reported as an add-on.
96116 is for a neurobehavioral status examination. 96112 is for developmental testing focused on developmental domains assessed with appropriate measures.
96130 covers psychological test evaluation. Use 96112 when the service is developmental testing, rather than psychological test evaluation.
The same code, a different location
In Bakersfield, the office rate for 96112 is $128.42—$0.52 higher than the $127.90 rate in Modesto. Both use the same code, release and participation basis.
Same release and payment basis · bars start at $0
Modesto · This locality
$127.90
$128.42
$0.52 higher than Modesto
$127.90
The same base rate than Modesto
$127.93
$0.03 higher than Modesto
$127.90
The same base rate than Modesto
$127.90
The same base rate than Modesto
$5.71 higher than Modesto
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
Across 109 of 109 CMS payment localities with a supported office rate, 96112 ranges from $118.04 in Arkansas to $168.19 in Alaska*. This is a geographic range, not an average.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
California · 96112
Office
$127.90
Facility
$107.77
The same base rate than Modesto for the office setting.
California · 96112
Office
$127.90
Facility
$107.77
The same base rate than Modesto for the office setting.
California · 96112
Office
$139.49
Facility
$115.28
$11.59 higher than Modesto for the office setting.
California · 96112
Office
$132.27
Facility
$110.55
$4.37 higher than Modesto for the office setting.
California · 96112
Office
$127.90
Facility
$107.77
The same base rate than Modesto for the office setting.
California · 96112
Office
$127.90
Facility
$107.77
The same base rate than Modesto for the office setting.
California · 96112
Office
$129.47
Facility
$109.34
$1.57 higher than Modesto for the office setting.
California · 96112
Office
$131.88
Facility
$110.51
$3.98 higher than Modesto for the office setting.
California · 96112
Office
$131.31
Facility
$110.02
$3.41 higher than Modesto for the office setting.
California · 96112
Office
$132.55
Facility
$110.58
$4.65 higher than Modesto for the office setting.
California · 96112
Office
$145.23
Facility
$119.32
$17.33 higher than Modesto for the office setting.
California · 96112
Office
$145.07
Facility
$119.16
$17.17 higher than Modesto for the office setting.
California · 96112
Office
$147.99
Facility
$121.50
$20.09 higher than Modesto for the office setting.
California · 96112
Office
$147.34
Facility
$120.85
$19.44 higher than Modesto for the office setting.
California · 96112
Office
$129.41
Facility
$108.49
$1.51 higher than Modesto for the office setting.
California · 96112
Office
$132.42
Facility
$110.10
$4.52 higher than Modesto for the office setting.
California · 96112
Office
$131.30
Facility
$109.88
$3.40 higher than Modesto for the office setting.
California · 96112
Office
$133.65
Facility
$111.09
$5.75 higher than Modesto for the office setting.
California · 96112
Office
$127.90
Facility
$107.77
The same base rate than Modesto for the office setting.
California · 96112
Office
$139.26
Facility
$115.05
$11.36 higher than Modesto for the office setting.
California · 96112
Office
$127.90
Facility
$107.77
The same base rate than Modesto for the office setting.
California · 96112
Office
$127.90
Facility
$107.77
The same base rate than Modesto for the office setting.
District of Columbia · 96112
Office
$136.64
Facility
$115.00
$8.74 higher than Modesto for the office setting.
Florida · 96112
Office
$133.84
Facility
$114.72
$5.94 higher than Modesto for the office setting.
Illinois · 96112
Office
$132.08
Facility
$113.62
$4.18 higher than Modesto for the office setting.
New York · 96112
Office
$139.15
Facility
$117.80
$11.25 higher than Modesto for the office setting.
Alaska · 96112
Office
$168.19
Facility
$148.62
$40.29 higher than Modesto for the office setting.
Alabama · 96112
Office
$118.84
Facility
$102.77
$9.06 lower than Modesto for the office setting.
Arkansas · 96112
Office
$118.04
Facility
$102.26
$9.86 lower than Modesto for the office setting.
Arizona · 96112
Office
$123.49
Facility
$105.69
$4.41 lower than Modesto for the office setting.
Colorado · 96112
Office
$127.50
Facility
$107.95
$0.40 lower than Modesto for the office setting.
Connecticut · 96112
Office
$130.65
Facility
$110.86
$2.75 higher than Modesto for the office setting.
Delaware · 96112
Office
$124.79
Facility
$106.64
$3.11 lower than Modesto for the office setting.
Florida · 96112
Office
$129.49
Facility
$110.88
$1.59 higher than Modesto for the office setting.
Florida · 96112
Office
$126.06
Facility
$108.50
$1.84 lower than Modesto for the office setting.
Georgia · 96112
Office
$127.01
Facility
$108.35
$0.89 lower than Modesto for the office setting.
Georgia · 96112
Office
$122.36
Facility
$105.98
$5.54 lower than Modesto for the office setting.
Hawaii · 96112
Office
$128.09
Facility
$107.20
$0.19 higher than Modesto for the office setting.
Iowa · 96112
Office
$119.45
Facility
$102.64
$8.45 lower than Modesto for the office setting.
Idaho · 96112
Office
$119.98
Facility
$103.08
$7.92 lower than Modesto for the office setting.
Illinois · 96112
Office
$127.19
Facility
$110.29
$0.71 lower than Modesto for the office setting.
Illinois · 96112
Office
$124.83
Facility
$108.06
$3.07 lower than Modesto for the office setting.
Illinois · 96112
Office
$130.41
Facility
$111.54
$2.51 higher than Modesto for the office setting.
Indiana · 96112
Office
$120.29
Facility
$103.26
$7.61 lower than Modesto for the office setting.
Kansas · 96112
Office
$119.57
Facility
$102.96
$8.33 lower than Modesto for the office setting.
Kentucky · 96112
Office
$120.96
Facility
$104.63
$6.94 lower than Modesto for the office setting.
Louisiana · 96112
Office
$123.82
Facility
$106.53
$4.08 lower than Modesto for the office setting.
Louisiana · 96112
Office
$121.02
Facility
$104.77
$6.88 lower than Modesto for the office setting.
Massachusetts · 96112
Office
$135.05
Facility
$113.11
$7.15 higher than Modesto for the office setting.
Massachusetts · 96112
Office
$127.53
Facility
$108.19
$0.37 lower than Modesto for the office setting.
Maryland · 96112
Office
$130.29
Facility
$110.58
$2.39 higher than Modesto for the office setting.
Maryland · 96112
Office
$126.15
Facility
$107.55
$1.75 lower than Modesto for the office setting.
Maine · 96112
Office
$120.68
Facility
$103.78
$7.22 lower than Modesto for the office setting.
Maine · 96112
Office
$123.21
Facility
$105.01
$4.69 lower than Modesto for the office setting.
Michigan · 96112
Office
$127.23
Facility
$109.51
$0.67 lower than Modesto for the office setting.
Michigan · 96112
Office
$122.81
Facility
$106.03
$5.09 lower than Modesto for the office setting.
Minnesota · 96112
Office
$122.98
Facility
$104.08
$4.92 lower than Modesto for the office setting.
Missouri · 96112
Office
$123.01
Facility
$105.76
$4.89 lower than Modesto for the office setting.
Missouri · 96112
Office
$123.58
Facility
$106.09
$4.32 lower than Modesto for the office setting.
Missouri · 96112
Office
$120.29
Facility
$104.46
$7.61 lower than Modesto for the office setting.
Mississippi · 96112
Office
$119.16
Facility
$103.34
$8.74 lower than Modesto for the office setting.
Montana · 96112
Office
$125.24
Facility
$106.87
$2.66 lower than Modesto for the office setting.
North Carolina · 96112
Office
$121.22
Facility
$104.08
$6.68 lower than Modesto for the office setting.
North Dakota · 96112
Office
$122.48
Facility
$104.11
$5.42 lower than Modesto for the office setting.
Nebraska · 96112
Office
$119.64
Facility
$102.69
$8.26 lower than Modesto for the office setting.
New Hampshire · 96112
Office
$126.11
Facility
$106.98
$1.79 lower than Modesto for the office setting.
New Jersey · 96112
Office
$136.57
Facility
$115.26
$8.67 higher than Modesto for the office setting.
New Jersey · 96112
Office
$132.35
Facility
$112.29
$4.45 higher than Modesto for the office setting.
New Mexico · 96112
Office
$123.28
Facility
$106.44
$4.62 lower than Modesto for the office setting.
Nevada · 96112
Office
$124.51
Facility
$106.12
$3.39 lower than Modesto for the office setting.
New York · 96112
Office
$141.36
Facility
$119.52
$13.46 higher than Modesto for the office setting.
New York · 96112
Office
$133.41
Facility
$113.30
$5.51 higher than Modesto for the office setting.
New York · 96112
Office
$139.18
Facility
$117.46
$11.28 higher than Modesto for the office setting.
New York · 96112
Office
$122.11
Facility
$104.66
$5.79 lower than Modesto for the office setting.
Ohio · 96112
Office
$122.24
Facility
$105.47
$5.66 lower than Modesto for the office setting.
Oklahoma · 96112
Office
$120.46
Facility
$104.05
$7.44 lower than Modesto for the office setting.
Oregon · 96112
Office
$129.32
Facility
$108.91
$1.42 higher than Modesto for the office setting.
Oregon · 96112
Office
$123.72
Facility
$105.43
$4.18 lower than Modesto for the office setting.
Pennsylvania · 96112
Office
$129.13
Facility
$110.01
$1.23 higher than Modesto for the office setting.
Pennsylvania · 96112
Office
$122.12
Facility
$105.26
$5.78 lower than Modesto for the office setting.
Puerto Rico · 96112
Office
$125.57
Facility
$107.00
$2.33 lower than Modesto for the office setting.
Rhode Island · 96112
Office
$127.53
Facility
$108.55
$0.37 lower than Modesto for the office setting.
South Carolina · 96112
Office
$121.89
Facility
$104.91
$6.01 lower than Modesto for the office setting.
South Dakota · 96112
Office
$122.15
Facility
$103.78
$5.75 lower than Modesto for the office setting.
Tennessee · 96112
Office
$119.90
Facility
$103.20
$8.00 lower than Modesto for the office setting.
Texas · 96112
Office
$126.93
Facility
$107.49
$0.97 lower than Modesto for the office setting.
Texas · 96112
Office
$121.76
Facility
$105.05
$6.14 lower than Modesto for the office setting.
Texas · 96112
Office
$124.59
Facility
$106.39
$3.31 lower than Modesto for the office setting.
Texas · 96112
Office
$125.22
Facility
$106.92
$2.68 lower than Modesto for the office setting.
Texas · 96112
Office
$124.93
Facility
$106.82
$2.97 lower than Modesto for the office setting.
Texas · 96112
Office
$124.89
Facility
$106.65
$3.01 lower than Modesto for the office setting.
Texas · 96112
Office
$127.45
Facility
$109.21
$0.45 lower than Modesto for the office setting.
Texas · 96112
Office
$123.01
Facility
$105.58
$4.89 lower than Modesto for the office setting.
Utah · 96112
Office
$122.67
Facility
$105.40
$5.23 lower than Modesto for the office setting.
Virginia · 96112
Office
$123.28
Facility
$105.22
$4.62 lower than Modesto for the office setting.
United States Virgin Islands · 96112
Office
$125.57
Facility
$107.00
$2.33 lower than Modesto for the office setting.
Vermont · 96112
Office
$122.59
Facility
$104.41
$5.31 lower than Modesto for the office setting.
Washington · 96112
Office
$127.11
Facility
$107.76
$0.79 lower than Modesto for the office setting.
Washington · 96112
Office
$136.63
Facility
$114.09
$8.73 higher than Modesto for the office setting.
Wisconsin · 96112
Office
$120.54
Facility
$102.95
$7.36 lower than Modesto for the office setting.
West Virginia · 96112
Office
$122.67
Facility
$106.71
$5.23 lower than Modesto for the office setting.
Wyoming · 96112
Office
$124.04
Facility
$105.67
$3.86 lower than Modesto for the office setting.
96112 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$118.04
$168.19
Color shows the midpoint of each state’s locality range.
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $168.19 | 1 |
| AL | $118.84 | 1 |
| AR | $118.04 | 1 |
| AZ | $123.49 | 1 |
| CA | $127.90–$147.99 | 29 |
| CO | $127.50 | 1 |
| CT | $130.65 | 1 |
| DC | $136.64 | 1 |
| DE | $124.79 | 1 |
| FL | $126.06–$133.84 | 3 |
| GA | $122.36–$127.01 | 2 |
| GU | $128.09 | 1 |
| HI | $128.09 | 1 |
| IA | $119.45 | 1 |
| ID | $119.98 | 1 |
| IL | $124.83–$132.08 | 4 |
| IN | $120.29 | 1 |
| KS | $119.57 | 1 |
| KY | $120.96 | 1 |
| LA | $121.02–$123.82 | 2 |
| MA | $127.53–$135.05 | 2 |
| MD | $126.15–$136.64 | 3 |
| ME | $120.68–$123.21 | 2 |
| MI | $122.81–$127.23 | 2 |
| MN | $122.98 | 1 |
| MO | $120.29–$123.58 | 3 |
| MS | $119.16 | 1 |
| MT | $125.24 | 1 |
| NC | $121.22 | 1 |
| ND | $122.48 | 1 |
| NE | $119.64 | 1 |
| NH | $126.11 | 1 |
| NJ | $132.35–$136.57 | 2 |
| NM | $123.28 | 1 |
| NV | $124.51 | 1 |
| NY | $122.11–$141.36 | 5 |
| OH | $122.24 | 1 |
| OK | $120.46 | 1 |
| OR | $123.72–$129.32 | 2 |
| PA | $122.12–$129.13 | 2 |
| PR | $125.57 | 1 |
| RI | $127.53 | 1 |
| SC | $121.89 | 1 |
| SD | $122.15 | 1 |
| TN | $119.90 | 1 |
| TX | $121.76–$127.45 | 8 |
| UT | $122.67 | 1 |
| VA | $123.28–$136.64 | 2 |
| VI | $125.57 | 1 |
| VT | $122.59 | 1 |
| WA | $127.11–$136.63 | 2 |
| WI | $120.54 | 1 |
| WV | $122.67 | 1 |
| WY | $124.04 | 1 |
Modesto is a Medicare payment area. Our Census mapping connects it to 33 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
For 96112 in Modesto, the physician’s office rate is $127.90 and the facility-setting rate is $107.77: a difference of $20.13.
The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.
Use this rate
Turn a percentage into dollars for 96112 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$140.69
$127.90 × 110% = $140.69
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 96112 in Modesto.
PPRRVU2026_Oct_nonQPP.csv
12,749
GPCI2026.csv
16
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.56 | × 1.017 | 2.6035 |
| Practice expense | 1.05 | × 1.096 | 1.1508 |
| Malpractice | 0.14 | × 0.536 | 0.0750 |
| Total RVUs | 3.8294 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Modesto$127.90
Open 96112 in the RVU calculator →
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.56 | 1.017 |
| Practice expense | 1.05 | 1.096 |
| Malpractice | 0.14 | 0.536 |
(2.56 × 1.017 + 1.05 × 1.096 + 0.14 × 0.536) × $33.4009 = $127.90
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.56 | 1.017 |
| Practice expense | 0.5 | 1.096 |
| Malpractice | 0.14 | 0.536 |
(2.56 × 1.017 + 0.5 × 1.096 + 0.14 × 0.536) × $33.4009 = $107.77
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
96112 · Office / nonfacility
$127.90
Effective 2026-10-01
The base rate is $1.74 lower than on 2025-10-01, moving from $129.64 to $127.90 (1.3%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
January 1, 2026
RVU26A
$129.64changed to$127.90
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
Earliest loaded release: $129.64
Held through RVU25B, RVU25C, RVU25D.
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
96112 represents a more complete developmental testing service with interpretation and a report. 96110 is used for a developmental screening with a score, rather than this full testing service.
96113 is the add-on code for additional developmental testing time beyond the initial hour represented by 96112. The record should support the additional time and the work performed.
96112 encompasses the developmental testing service, including interpretation and reporting for the initial hour. Do not split those elements into separate services under this code.
Document the standardized assessment, domains evaluated, time supporting the service, findings, interpretation, and resulting report. The record should show a developmental evaluation rather than only a brief screening.
No. 96112 is developmental testing using assessment measures and interpretation; 96116 addresses a neurobehavioral status examination, a different type of clinical evaluation.
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
