HCPCS code G0451: Developmental testing2026 Medicare rate & RVUs in Oklahoma
Reports standardized developmental testing with interpretation for an assessment of a patient's developmental skills, such as when developmental delay is suspected.
Medicare pays $11.00 for G0451 in the office in Oklahoma (Oklahoma). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What G0451 covers
G0451 represents standardized testing of developmental skills, with interpretation and a report. It may be used when a clinician evaluates a child for a suspected developmental delay, using an instrument to assess areas such as language, motor, cognitive, or adaptive functioning. The service is distinct from a brief developmental screen: it includes interpretation of the test results and documentation of findings. It is commonly furnished in an outpatient clinical setting by clinical staff working under physician supervision.
Select the code when the documented service is standardized developmental testing with interpretation and a report, rather than a limited screening or a different type of behavioral assessment. The record should identify the instrument, testing performed, results, interpretation, and report. Medicare requires this incident-to service to be performed under physician supervision. The CMS file assigns no physician work RVU; its valuation is represented through practice-expense and malpractice RVUs. Interpretation and reporting are part of the service described by G0451, not separate pieces of this testing service.
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.
G0451 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | $11.00 | Unavailable |
How the G0451 rate is calculated
Each of G0451’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 · G0451
RVUs × geographic indexes × conversion factor
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 G0451
The CMS indicators that decide how G0451 is paid alongside other services.
CMS payment indicators · G0451
Developmental testing
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 5 | Incident-to service. |
G0451 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 96110Developmental screen w/score
- 96110 represents a limited developmental screen. G0451 is used for standardized developmental testing that includes interpretation and a report.
- 96112Developmental testing
- 96112 is time-based developmental testing under CPT criteria. G0451 describes testing per standardized instrument; choose based on the service performed and applicable code criteria.
- 96113Developmental testing
- 96113 is an additional-time code used with 96112. It is not a standalone substitute for G0451's per-instrument service.
G0451 billing questions
How is G0451 different from a developmental screening code?
G0451 describes standardized developmental testing with interpretation and a report. A limited screening, such as the service represented by 96110, is not the same level of testing.
What documentation supports G0451?
Document the standardized instrument, testing performed, results, interpretation, and report. The record should also support that the service was performed under physician supervision.
Can the interpretation or report be billed separately?
The interpretation and report are included in G0451's testing service. The code does not describe testing administration alone.
Does G0451 require physician supervision?
Yes. CMS identifies G0451 as an incident-to service and allows billing only when it is performed under physician supervision.
When might 96112 be a better fit?
Consider 96112 when the service meets the CPT criteria for time-based developmental testing by a physician or other qualified health care professional. G0451 describes testing per standardized instrument.
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
Show the CMS file lines behind this rate
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