G0451 HCPCS code: Development testing, with interpretation and report, per standardized instrument form

G0451 is the HCPCS Level II code for development testing, with interpretation and report, per standardized instrument form. In 2024 Medicare paid an average of $8.11 per service for G0451 across 651 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 1 per day on outpatient hospital claims. In 2024, about 16 clinicians billed Medicare for G0451 for 627 beneficiaries.

Code details

Who bills G0451 (2024)

Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.

Medicare utilization for G0451, 2022–2024

States with the most G0451 services (2024)

NCCI unit limits (MUE)

Medicare policy articles for this code

• A52866: Billing and Coding: Speech-Language Pathology (National Government Services, Inc. (MAC - Part A, MAC - Part B))
• A56937: Billing and Coding: Psychiatry and Psychology Services (National Government Services, Inc. (MAC - Part A, MAC - Part B))
• A57130: Billing and Coding: Psychiatric Codes (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B))
• A57780: Billing and Coding: Psychological and Neuropsychological Tests (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B))

Covered diagnoses (2,232 ICD-10-CM codes)

The diagnoses most often listed as covered in the policy articles above:

Showing 10 of 2,232. The full list, non-covered diagnoses and CSV export are in Caduvo.

What changed for G0451

• 2012-01-01: G0451 added to HCPCS Level II
• Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01

Frequently asked questions

What is HCPCS code G0451?

G0451 is the HCPCS Level II code for development testing, with interpretation and report, per standardized instrument form. Short descriptor: "Devlopment test interpt&rep".

How much does Medicare pay for G0451?

In 2024, the average Medicare payment was $8.11 per service (average allowed $11.50).

Does Medicare cover G0451?

Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.

Which diagnoses support coverage for G0451?

Medicare policy articles that cite G0451 list 2,232 covered ICD-10-CM diagnosis codes across 4 articles. The most cited include F80.0 (Phonological disorder), F80.1 (Expressive language disorder), F80.2 (Mixed receptive-expressive language disorder). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.

How many units of G0451 can be billed per day?

1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).

Related G04 codes

• G0400 — Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels
• G0402 — Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment
• G0403 — Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report
• G0404 — Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination
• G0405 — Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination
• G0406 — Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth
• G0407 — Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth
• G0408 — Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth
• G0409 — Social work and psychological services, directly relating to and/or furthering the patient's rehabilitation goals, each 15 minutes, face-to-face; individual (services provided by a corf-qualified social worker or psychologist in a corf)
• G0410 — Group psychotherapy other than of a multiple-family group, in a partial hospitalization or intensive outpatient setting, approximately 45 to 50 minutes
• G0411 — Interactive group psychotherapy, in a partial hospitalization or intensive outpatient setting, approximately 45 to 50 minutes
• G0412 — Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed

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Next steps

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Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.

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