CPT® Code 96113

Add-On Code

Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report; each additional 30 minutes (List separately in addition to code for primary procedure)

The CPT® Code 96113 refers to the administration of developmental tests, which are essential tools used to evaluate and monitor the acquisition of expected skills in individuals from infancy through adolescence. These tests help confirm the presence and extent of disabilities across various developmental domains. The five primary domains assessed include communication, cognitive, physical, social/emotional, and adaptive skills. Communication tests focus on an individual's ability to receive, send, process, and comprehend information through verbal, non-verbal, and graphic means. Cognitive assessments evaluate critical thinking, reasoning, problem-solving abilities, and may also encompass memory, intelligence, attention, and executive functioning skills. The physical domain assessment includes a comprehensive evaluation of health status, sensory capabilities such as hearing and vision, and the development of gross and fine motor skills, muscle tone, and overall physical limitations. Social-emotional development is assessed through the ability to form attachments, express emotions, and respond appropriately to the emotional states of others. Lastly, the adaptive domain measures the acquisition of skills necessary for coping with daily physical and environmental demands, including activities such as sleeping, eating, toileting, and mobility. Standardized assessment tools utilized in this process may focus on a single domain or encompass multiple areas of development. Commonly used tests include the Peabody Picture Vocabulary Test (PPVT), Clinical Evaluation of Language Fundamentals (CELF), and the Woodcock-Johnson Test of Cognitive Abilities, among others. Code 96112 is used to report the first hour of developmental test administration, while code 96113 is designated for each additional 30 minutes of testing performed by a physician or other qualified healthcare professional, including the interpretation of results and the generation of a report.