PCL-5: PTSD Checklist for DSM-5-TR
The PCL-5 (PTSD Checklist for DSM-5) is a 20-item self-report questionnaire that measures the severity of the 20 DSM-5-TR symptoms of PTSD over the past month. Total scores range from 0 to 80; a score of 31–33 or higher indicates probable PTSD.
PCL-5 Score Interpreter
Score 33–80. At or above the provisional cutoff; confirm with a structured clinical interview such as the CAPS-5.
20 items rated 0 (not at all) to 4 (extremely) for the past month; sum for a total of 0–80. A provisional result also needs the symptom-count pattern and confirmation of trauma exposure (Criterion A), which the PCL-5 does not assess.
| Total score | Interpretation |
|---|---|
| 33+ | Probable PTSDScore 33–80. At or above the provisional cutoff; confirm with a structured clinical interview such as the CAPS-5. |
| 0–32 | Below provisional cutoffScore 0–32. Below the recommended cutoff of 33. Scores of 31–32 sit in the 31–33 range that some samples use as the threshold, so interpret alongside clinical presentation. |
Bovin et al. (2016): scores of 31–33 were optimally efficient for diagnosing PTSD against the CAPS-5; the National Center for PTSD uses 31–33 as indicative of probable PTSD. Educational reference only — not a diagnostic tool.
For reference only — not an assessment, diagnosis, or medical advice. This page provides scoring reference material; interpretation and clinical decisions rest with a qualified clinician.
Foundational Context
The PCL-5 (PTSD Checklist for DSM-5-TR) was developed by the National Center for PTSD (Weathers et al., 2013) to align with updated DSM-5-TR criteria. It replaces previous versions (PCL-C, PCL-M) and is one of the most widely used self-report tools for monitoring PTSD symptom severity.
It is used in VA settings, civilian practice, and research to screen for PTSD, monitor treatment progress, and support measurement-based care.
What the PCL-5 measures
The 20 items of the PCL-5 correspond to the four DSM-5-TR PTSD symptom clusters:
- Criterion B: Intrusion (Items 1–5): Unwanted memories, nightmares, flashbacks, and reactivity.
- Criterion C: Avoidance (Items 6–7): Avoidance of internal and external reminders.
- Criterion D: Negative Cognitions & Mood (Items 8–14): Negative beliefs, emotional numbing, and loss of interest.
- Criterion E: Arousal & Reactivity (Items 15–20): Irritability, hypervigilance, and sleep disturbance.
Each item is rated 0 (Not at all) to 4 (Extremely) based on the past month.
How to administer the PCL-5
- Time: 5–10 minutes.
- Index Trauma: Ideally, identify a specific index trauma (Criterion A) with the client before rating symptoms.
- Diagnosis: A full clinical evaluation requires verification of Criterion A trauma exposure and a structured interview like the CAPS-5.
- Integration: Often administered with the PHQ-9 and GAD-7 as depression frequently co-occurs with PTSD.
PCL-5 scoring and interpretation
Total scores range from 0 to 80.
- Provisional PTSD Threshold: A total score of 33 or higher is the recommended cutoff for probable PTSD (Bovin et al., 2016).
- Symptom-Count Method: Probable PTSD is also supported if at least one item per cluster (B and C) and two items per cluster (D and E) are rated ≥2 ("Moderately").
Monitoring Progress:
- 5–10 point change: Reliable change (beyond measurement error).
- 10–20 point change: Clinically significant change.
DSM-5-TR Cluster Criteria (Symptom-Count Approach)
For provisional DSM-5-TR symptom-count analysis, items scored ≥2 (Moderately) are treated as endorsed. The following minimum endorsements are required across all four clusters:
- Criterion B (Intrusion, Items 1–5): at least 1 item rated ≥2.
- Criterion C (Avoidance, Items 6–7): at least 1 item rated ≥2.
- Criterion D (Negative Cognitions & Mood, Items 8–14): at least 2 items rated ≥2.
- Criterion E (Arousal & Reactivity, Items 15–20): at least 2 items rated ≥2.
A cluster threshold is "met" when the minimum number of items listed above for that cluster score ≥2 (Moderately). Meeting all four cluster thresholds and a total score ≥33 supports a provisional PTSD determination; full clinical evaluation requires a structured clinical interview.
A formal PTSD diagnosis requires meeting Criterion A (trauma exposure) in addition to the above cluster thresholds. The PCL-5 does not assess Criterion A. Clinicians should confirm trauma exposure through a structured interview or the Life Events Checklist for DSM-5-TR (LEC-5).
Documenting PCL-5 Scores in Clinical Notes
PCL-5 total and cluster scores belong in the Objective section. See our SOAP notes guide and therapy progress notes guide for templates and examples.
Psychometric properties
- Development study (Blevins et al., 2015; trauma-exposed college students, N = 278): strong internal consistency (α = .94), test-retest reliability (r = .82), convergent validity (rs = .74 to .85) and discriminant validity (rs = .31 to .60). A second study (N = 558) showed similarly strong reliability and validity.
- Veterans (Bovin et al., 2016; N = 468): internal consistency α = .96, test-retest reliability r = .84, and good convergent and discriminant validity. Against the CAPS-5, scores of 31 to 33 were optimally efficient for diagnosing PTSD.
- Factor structure: the data fit the DSM-5 four-factor model adequately, with better fit for the six-factor anhedonia and seven-factor hybrid models.
- Sensitivity: Highly responsive to trauma-focused treatments (e.g., CPT, PE).
Limitations
- Does not assess Criterion A (trauma exposure) directly.
- Self-report may be influenced by avoidance or limited insight into arousal symptoms.
This library is an academic and clinical reference. A scale described here is not necessarily offered in HiBoop; each page says whether it is.
Frequently Asked Questions
What is the PCL-5?
The PCL-5 is a 20-item self-report PTSD severity scale aligned with DSM-5-TR criteria, scoring 0 to 80 across the past month. Each item maps to one of the 20 DSM-5-TR PTSD symptoms organized into four clusters: intrusion, avoidance, negative cognitions and mood, and arousal and reactivity. Developed by Weathers et al. (2013) at the National Center for PTSD.
How do you score the PCL-5?
Each of the 20 items is rated 0 (not at all) to 4 (extremely) based on how much the symptom bothered the respondent in the past month. Item scores are summed for a total ranging from 0 to 80. Cluster subscores can also be calculated: intrusion (items 1-5), avoidance (items 6-7), negative cognitions and mood (items 8-14), and arousal and reactivity (items 15-20).
Can I bill CPT 96127 for the PCL-5?
CPT 96127 (brief emotional/behavioural assessment) reimburses standardized scales of approximately 5 to 10 minutes; the PCL-5 typically takes 5 to 10 minutes and is commonly billed under 96127 when administered, scored, and documented with clinical interpretation. Up to four scales can be billed per visit. Documentation must include score, cluster pattern, and clinical action.
What ICD-10 code does the PCL-5 support?
The PCL-5 supports ICD-10-CM code F43.10 (Post-Traumatic Stress Disorder, unspecified), F43.11 (PTSD, acute), and F43.12 (PTSD, chronic). It is also used to support F43.0 (Acute Stress Reaction) when symptoms are present for less than one month following trauma exposure.
How accurate is the PCL-5?
At a cutoff of 33 or higher, the PCL-5 has approximately 80% sensitivity and 70% specificity for PTSD diagnosis in veteran samples (Bovin et al., 2016). The scale shows strong internal consistency and convergent validity with clinician-administered measures such as the CAPS-5. A reliable change of 5 to 10 points indicates clinically meaningful symptom reduction.
Bill this assessment
In the US, the PCL-5: PTSD Checklist for DSM-5-TR is usually billed under these CPT codes. Payer rules vary.
Using this assessment in practice
For clinicians
Send it as a gentle check-in before the session. The score is waiting when you open the chart, and the trend builds itself.
For individuals
This page is a clinical reference, not a diagnostic tool. If you have concerns about your own symptoms, bring this information to a qualified mental health professional.
References
- 1.Blevins CA, Weathers FW, Davis MT, Witte TK, Domino JL. The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): development and initial psychometric evaluation. J Trauma Stress. 2015;28(6):489-498.View source
- 2.Bovin MJ, Marx BP, Weathers FW, et al. Psychometric properties of the PTSD Checklist for DSM-5 (PCL-5) in veterans. Psychol Assess. 2016;28(11):1379-1391.View source
- 3.Weathers FW, Litz BT, Keane TM, Palmieri PA, Marx BP, Schnurr PP. The PTSD Checklist for DSM-5 (PCL-5). National Center for PTSD; 2013.View source
Last reviewed: Jun 2, 2026
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