G0451 Devlopment test interpt&rep

Development testing, with interpretation and report, per standardized instrument form

Medically Unlikely Edits (effective October 1, 2026)

Medicare pricing for G0451

Physician Fee Schedule (CY 2026, RVU26D)

Status A: active, paid separately under the PFS if covered. National amounts: non-facility $12.36, facility $12.36 (total RVUs 0.37 / 0.37 × $33.4009 conversion factor; facility NA: rarely or never done in that setting). Work RVU 0.00, practice expense RVU 0.36 non-facility and 0.36 facility, malpractice RVU 0.01. Global period XXX. Qualifying APM participants are paid at a $33.5675 conversion factor.

Payer policies and prior authorization for G0451

Payer coverage policies that name G0451

G0451 appears in 2 coverage policies from Aetna, Premera Blue Cross.

PayerPolicyRole in policyReviewedDocument
AetnaEarly Intervention Programs (0444)listed, no stanceJul 1, 2026payer document
Premera Blue CrossPreventive Care
Fluoride supplements Developmental screening Including autism		covered if criteria are metSep 21, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • CO: $6.18 (chp_plus, non-facility), effective Jul 1, 2026
  • KY: $7.01 (speech_therapy, therapist, facility), effective Jan 1, 2026
  • ND: $0.00 (physician), effective Aug 1, 2026
  • VA: $6.68 (medical), effective Jan 1, 2012
  • VT: $78.88 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $44.93 (outpatient_hospital_apc, Ambulatory Surgical Centers), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.