CPT Code 96112: Developmental testing, first hour

What is 96112 cpt code?

CPT code 96112 is used to report the first hour of developmental testing services conducted by a qualified health care professional. This includes the administration of standardized tests, scoring, interpretation of results, and a written report. Developmental testing is typically performed to evaluate cognitive, motor, language, social, or emotional development in infants, children, or adolescents.

This code is commonly used in pediatric settings to assess for developmental delays, autism spectrum disorder (ASD), intellectual disability, and other neurodevelopmental concerns using standardized developmental instruments. It may also support treatment planning, early intervention referrals, or school-based service eligibility.

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CPT code 96112 documentation requirements

Accurate and detailed documentation is essential to justify the use of CPT code 96112 and support medical necessity. This code reflects the first hour of developmental test administration by a qualified healthcare professional and must be supported by clinical rationale, validated tools, and clear reporting. The following elements should be included in the patient’s medical record to ensure accurate billing and compliance with coding guidelines.

Clinical indication and medical necessity

Clearly state the clinical reason for the developmental assessment. Common indications include diagnosing developmental delays, evaluating developmental disorders, or investigating concerns related to speech and language, cognition, motor skills, or social-emotional functioning. Include any relevant history, developmental screening results, or risk factors that prompted the referral for comprehensive testing.

Description of tests administered

Document the standardized instruments used during the developmental testing session, such as the Bayley Scales of Infant and Toddler Development, Ages and Stages Questionnaires (ASQ), Vineland Adaptive Behavior Scales, or Battelle Developmental Inventory. Clarify whether the tools were administered directly to the child or via a parent or caregiver report. These details support the validity and structure of the assessment process.

Time tracking

Include start and stop times for the session to support time-based billing. CPT 96112 accounts for the first 60 minutes of the provider’s time spent on test selection, administration, scoring, result interpretation, and the development of a written report. Only time actively engaged in these activities may be billed—breaks or unrelated services must be excluded.

Interpretation and written report

A formal interpretation of results and a comprehensive written report must be included in the patient record. This report should summarize performance across various developmental domains, identify strengths and concerns, provide clinical impressions, and offer recommendations for follow-up, intervention, or referrals to other healthcare providers or services. This documentation is vital for communicating findings and supporting treatment planning.

CPT code 96112 billing guidelines

To ensure correct CPT code selection and reimbursement, healthcare providers must follow established CPT coding guidelines and payer-specific rules. CPT 96112 reflects provider-performed developmental testing and should not be confused with services performed by technicians or brief screenings.

Who can bill 96112?

Only a qualified healthcare professional, such as a licensed psychologist, developmental pediatrician, speech-language pathologist, or other credentialed provider acting within their legal scope of practice, may report CPT 96112. Technician-administered testing is not billable under this code.

Report in time-based units

CPT 96112 represents the first hour of direct service. If the developmental testing session exceeds 60 minutes, CPT code 96113 must be reported for each additional 30 minutes. Providers must ensure accurate documentation of time spent on billable components, including test administration and scoring, interpretation, and report writing.

Do not bundle with other testing codes

CPT 96112 must be billed separately from psychological or neuropsychological testing codes (e.g., 96130, 96132). If these additional services are performed during the same encounter, ensure that they are distinct, medically necessary, and clearly documented. Use appropriate modifiers when required to distinguish between overlapping services.

Check payer policies

Coverage for 96112 can vary across insurance plans. Some payers may limit the frequency of developmental testing, require prior authorization, especially for evaluations related to autism spectrum disorder, or specify conditions under which developmental assessments are reimbursable. Always review payer-specific coverage criteria in advance to avoid denials and delays in claim processing.

Other relevant CPT codes

• 96113 – Developmental testing, each additional 30 minutes (add-on to 96112)
• 96110 – Developmental screening and testing
• 96130 – Psychological testing evaluation services, first hour