Learn · Pediatric coding

Developmental screening coding: CPT 96110

Q: What is the difference between 96110 and 96112?

96110 is developmental screening — a brief, standardized instrument that is scored and documented to flag children who may need further evaluation. 96112 and 96113 are developmental testing — a comprehensive, clinician-administered assessment with interpretation and a written report, billed by time (96112 first hour, add-on 96113 each additional 30 minutes). Screening identifies; testing diagnoses.

Q: What documentation supports 96110?

96110 requires a standardized, validated screening instrument (such as the ASQ or M-CHAT) with the result scored and the score recorded, plus the provider's interpretation. The recorded score and interpretation — not the blank form — are what is reimbursed.

By the Capsa Coding team Last updated June 3, 2026 Reviewed against primary sources (AMA CPT, AAP, AAFP)

Quick answer

CPT 96110 reports developmental screening — a brief, standardized instrument (such as the ASQ or M-CHAT) that is scored and documented to flag children who may need further evaluation. It's distinct from developmental testing (96112 for the first hour, add-on 96113 for each additional 30 minutes), which is a comprehensive, clinician-administered assessment with interpretation and a written report. Screening identifies; testing diagnoses.

What 96110 covers

Per the AMA CPT and AAP guidance, 96110 is reported for developmental screening with scoring and documentation, per standardized instrument. In practice that means a validated screening tool — often completed from a caregiver's observations — that is scored on the instrument and interpreted by the provider. Common examples include the Ages & Stages Questionnaire (ASQ) and the Modified Checklist for Autism in Toddlers (M-CHAT).

An important nuance for reimbursement: payers pay for the scored, interpreted result — not for the blank form. The documentation that supports 96110 is the named instrument, the recorded score, and the provider's interpretation.

Screening (96110) vs testing (96112 / 96113)

The most common mix-up is treating screening and testing as interchangeable. They aren't:

	96110 · Screening	96112 / 96113 · Testing
Purpose	Brief preliminary check — who needs further evaluation	Comprehensive assessment — characterize a delay
How	Standardized instrument, scored & documented	Clinician-administered testing with interpretation & report
Billing basis	Per standardized instrument	Time-based (96112 first hour; +96113 each extra 30 min)

How it's reimbursed

96110 is widely reimbursed by Medicaid as part of EPSDT (Early and Periodic Screening, Diagnostic, and Treatment), though rates, age limits, and frequency rules vary by state and payer. Medicare generally doesn't cover 96110 and uses HCPCS code G0451 instead.

Scope & accuracy: CPT descriptors are owned by the AMA; the codes above are summarized, not reproduced verbatim. Coverage, age limits, units, and frequency vary by payer and state, and codes change — verify against current CPT and your payers. This page is educational, not coding advice.

How Capsa codes developmental screening

Health and developmental screening is one of Capsa's validated live skills. Capsa reads the signed note, recognizes when a standardized screen was completed and scored, and recommends 96110 — cited to the verbatim chart text (the named instrument and recorded score). Screening units are easy to miss, which makes them a frequent source of revenue leakage; Capsa measures its performance here with scope-aware precision and recall against what coders actually billed.

Frequently asked questions

What's the difference between 96110 and 96112?+

96110 is developmental screening — a brief, standardized, scored instrument that flags children who may need further evaluation. 96112/96113 are developmental testing — a comprehensive, clinician-administered assessment with interpretation and a written report, billed by time. Screening identifies; testing diagnoses.

Is CPT 96110 reimbursed?+

Often, especially by Medicaid as part of EPSDT, though reimbursement and age limits vary by payer. Medicare generally doesn't cover 96110 and uses HCPCS code G0451 instead. Payers reimburse the scored, interpreted result — not the form itself.

What documentation supports 96110?+

A standardized, validated instrument (such as the ASQ or M-CHAT) with the result scored and recorded, plus the provider's interpretation. The recorded score and interpretation — not the blank form — are what's reimbursed.

Can 96110 be reported more than once per visit?+

Each standardized instrument administered and scored may support a unit of 96110, subject to payer rules — for example, a developmental screen and a separate autism-specific screen. Always check the specific payer's policy.

Sources

American Academy of Family Physicians (AAFP), “Four screening codes you should be using.” aafp.org
AAPC, Developmental and Behavioral Screening and Testing (96110–96113). aapc.com
American Medical Association, CPT (Current Procedural Terminology). ama-assn.org