PCL-5 Scoring and How to Document It in a Progress Note
Facts checked against the primary sources listed below. Last reviewed . Last updated: . See sources.
How is the PCL-5 scored?
The PCL-5 is a 20-item self-report measure of the 20 DSM-5 symptoms of PTSD. Each item is scored 0 to 4 and the items are summed for a total of 0 to 80. The VA National Center for PTSD says a cutoff between 31 and 33 is indicative of probable PTSD across samples.
The PTSD Checklist for DSM-5 (PCL-5) was developed by staff at the VA National Center for PTSD. Clinicians use it to monitor symptom change during and after treatment, to screen for PTSD, and to support a provisional PTSD diagnosis.
The standard version asks about the past month, and the Center also publishes a past-week version. This guide covers scoring, the cluster structure, the provisional cutoff, and how to write the result into a SOAP or DAP note. It does not reproduce the items: use the official form linked in the sources.
PCL-5 at a glance
| Detail | What the sources say |
|---|---|
| What it is | A 20-item self-report measure that assesses the 20 DSM-5 symptoms of PTSD. |
| Developed by | Staff at the VA National Center for PTSD. |
| Items and item scores | 20 items on a 5-point scale, from 0 (not at all) to 4 (extremely). |
| Total score | 0 to 80, from summing the 20 items. |
| Time frame asked about | Past month for the standard form. A separate past-week form is also published. |
| Uses listed by the VA | Monitoring symptom change during and after treatment, screening individuals for PTSD, and making a provisional PTSD diagnosis. |
| Gold standard for diagnosis | The VA says a structured clinical interview such as the Clinician-Administered PTSD Scale (CAPS-5) is the gold standard for diagnosing PTSD. |
PCL-5 scoring elements
| Element | Range or rule | Source note |
|---|---|---|
| Item score | 0 to 4 | Five response options from not at all to extremely. |
| Total symptom severity score | 0 to 80 | Sum of the 20 items. |
| Provisional cutoff | 31 to 33 | Indicative of probable PTSD across samples, per the VA, based on initial research. |
| Cluster B (intrusion) | Items 1 to 5 | Subscore by summing these items. |
| Cluster C (avoidance) | Items 6 to 7 | Subscore by summing these items. |
| Cluster D (negative alterations in cognition and mood) | Items 8 to 14 | Subscore by summing these items. |
| Cluster E (alterations in arousal and reactivity) | Items 15 to 20 | Subscore by summing these items. |
What does the PCL-5 cutoff of 31 to 33 mean?
The VA National Center for PTSD states: "Initial research suggests that a PCL-5 cutoff score between 31-33 is indicative of probable PTSD across samples." Use the word probable in your note. The cutoff is a screening and provisional-diagnosis aid, and the same page names a structured clinical interview such as the CAPS-5 as the gold standard for diagnosis.
Because the VA gives a range rather than a single number, document the actual total and let the reader see where it falls. A total of 45, for example, is plainly above the range, while 32 sits inside it and deserves a clinical explanation in your Assessment.
How do the DSM-5 symptom clusters fit into the score?
The VA groups the 20 items by DSM-5 cluster: B (items 1 to 5), C (items 6 to 7), D (items 8 to 14) and E (items 15 to 20). Summing the items in a cluster gives a cluster subscore. Reporting the cluster scores can show where treatment is working, for example intrusion falling while avoidance stays high.
The VA's page lists the PCL-5 alongside the Life Events Checklist for DSM-5 (LEC-5) and an extended Criterion A assessment. If you use those, note in your record which index event the client had in mind when completing the PCL-5.
Which version should you use: past month or past week?
The standard form is labeled "PCL-5, Past Month," and the VA publishes a separate "PCL-5, Past Week" form. Record which form you used every time so that scores from the two windows are never compared as if they were the same. The VA's cutoff statement does not say which window it applies to, so keep that in mind when you cite it.
How do you document it in a progress note?
- Step 1: State that the PCL-5 was given, which version (past month or past week), and the date.
- Step 2: Record the total score (0 to 80) and say whether it falls below, within or above the 31 to 33 range.
- Step 3: Add cluster subscores when you track them across sessions.
- Step 4: Note the prior score and the trend.
- Step 5: Put your clinical interpretation in the Assessment and avoid wording that treats the cutoff as a diagnosis.
- Step 6: State the plan, including when you will repeat the measure.
Where the PCL-5 goes in each note format
| Note format | Where the score goes | Where the interpretation goes |
|---|---|---|
| SOAP | Objective: version, total, cluster subscores and prior score. | Assessment: what the score and trend mean for this client. |
| DAP | Data: version, total, cluster subscores and prior score. | Assessment: what the score and trend mean for this client. |
Example wording (fictional, for illustration only)
Objective: PCL-5 (past month) completed in session on 10/09, total 38, down from 52 at the start of treatment; the cluster D subscore remains the highest. Assessment: Total remains above the 31 to 33 provisional range, consistent with continued PTSD symptoms, though intrusion has decreased. Plan: continue trauma-focused sessions and repeat the PCL-5 in four weeks.
Is the PCL-5 free to use?
The VA National Center for PTSD states: "This measure was developed by staff at VA's National Center for PTSD and is in the public domain and not copyrighted." The forms are downloadable from the Center's page linked in the sources, which is the version to use.
Frequently Asked Questions
What is a positive score on the PCL-5?
The VA National Center for PTSD says initial research suggests that a cutoff between 31 and 33 is indicative of probable PTSD across samples. Treat it as a provisional screening result and confirm with a clinical evaluation.
What is the maximum PCL-5 score?
The maximum is 80. There are 20 items scored from 0 to 4, and the total symptom severity score is the sum of all 20.
How long a period does the PCL-5 cover?
The standard form asks about the past month. The VA also publishes a past-week version. Record which one you used so scores stay comparable.
Can the PCL-5 diagnose PTSD?
It can support a provisional diagnosis, according to the VA, but the gold standard for diagnosing PTSD is a structured clinical interview such as the CAPS-5. Diagnosis remains the treating clinician's decision.
Is the PCL-5 in the public domain?
Yes. The VA National Center for PTSD states that the measure was developed by its staff and is in the public domain and not copyrighted.
Does WellNotes score the PCL-5?
No. You score the PCL-5 yourself and write the result in your note. WellNotes drafts the session note from what you type or dictate, and you review it.
Related references
Sources
This page is general reference information, not clinical, coding, or legal advice. Scoring rules and usage terms can change, so confirm them on the instrument owner's current materials and with your payer or supervisor before relying on them. WellNotes does not administer or score screening tools. The treating clinician interprets every result.
Draft the session note with the score in it
Type or dictate the session, include the score and your interpretation, and WellNotes drafts the note in SOAP, DAP, or BIRP. You review and edit every note.