Description
Current Procedural Terminology (CPT) codes for screening and developmental testing.
Although it won’t garner as much publicity as the Mad Cow scare, there has been a small earthquake in the reimbursement world. The year 2003 saw two codes specifically relating to ‘developmental and behavioral’ pediatrics approved by CMS and thereby setting the path for reimbursement for the services these codes cover.
These CPT codes were
- 96110: Developmental Screening
- 96111: Developmental Testing
As background information, all CPT codes have three components contributing to the amount of reimbursement they allow:
- Practice Expense
- Physician Work
- Malpractice
Practice expenses can include the non-renewable physical instruments/implements. Physician work is the time and complexity of the physician cognitive and physical work and the malpractice component is the ‘relative risk’ of creating a situation in which ‘harm could be done’ to the patient.
In the realm of developmental and behavioral topic, the Malpractice factor is quite small. The practice expense is dictated by the cost(s) of the instruments CPT 96110 “Developmental Screening” was an existing code that did not have ‘practice expense’ factored in and therefore was not a ‘big ticket’ item for most physicians providing services to children.
Keywords: CPT (practice),Current Procedural Terminology,developmental testing,office practice,practice management,prolonged service,reimbursement,screening
Publication date: Jun 6, 2004
Revise date: Jan 27, 2006
TextID: 123
