September 28, 2026 · AxonCPT Team · CPT, ADHD assessment, remote assessment, clinical practice

CPT Tests Compared: TOVA, Conners CPT 3, QbCheck, IVA-2

Four continuous performance tests (CPTs) dominate clinician searches for objective ADHD testing: T.O.V.A. 9, Conners CPT 3 Online, QbCheck, and IVA-2. They measure similar constructs — sustained attention, impulsivity, and response variability — but differ sharply in setting, hardware, age range, regulatory status, and price. This guide lines up the published facts on all four so you can match a test to your workflow rather than your search results.

Adult concentrating on a computer screen, representing a continuous performance test Photo by litoon dev on Unsplash

Disclosure: AxonCPT publishes this comparison and makes a competing product, described near the end. This article isn’t affiliated with or endorsed by any vendor named here. Facts are vendor-published, accessed September 27, 2026, unless noted — verify with each vendor before you buy.

The four CPTs at a glance

T.O.V.A. 9 Conners CPT 3 Online QbCheck IVA-2
Setting In-clinic; no remote option found on the vendor site [1] Local or remote (remote for CPT 3 only, not K-CPT 2 or CATA) [4] Remote via QbPath portal, or in-clinic [6] In-clinic, or remote with a paid add-on license; examiner must view the patient throughout via A/V [10]
Hardware Proprietary USB device plus microswitch, Windows or Mac PC [1][3] Web app on MHS’s MAC+ platform, no special hardware [4] Mac or Windows laptop with a built-in webcam; Intel Core i5+ [8] Windows 11 PC; iPad/iPhone or Chrome browser for the remote add-on [10][11]
Test length 21.6 min (10.8 min for ages 4–5.5) [2] 14 min (K-CPT 2: 7.5 min; CATA: 14 min) [4] 15 or 20 min by age, plus setup [8] ~13 min core, combined visual and auditory [11]
Ages (vendor) Visual 4–80+, auditory 6–29 [2] CPT 3 and CATA: 8+; K-CPT 2: 4–7 [4] 6–60 [6] 6–96 [11]
FDA 510(k) K170082 (2017), K173915 (2018); product code LQD [13] No clearance claim found; no openFDA record [13] K143468 (2016); product code LQD [13] No clearance found; remote page states products are “not medical devices” and make “no medical claims” [10]
Published price $1,095 system (includes 5 credits), $15/credit [1] $10/use, minimum purchase 15 ($150) [4] From $68/test, credits valid 12 months [6] Standard kit $975 (5 tests, 5 reports); Remote Testing License $695 add-on [9]

How do these four CPTs differ in setting and hardware?

T.O.V.A. 9 is an in-clinic test built around a proprietary USB response device and microswitch, described by the vendor as “highly accurate (±1 ms)” [2]. It runs on Windows or Mac, but not on Chromebooks, iPads, or Android devices [3], and we found no remote administration option on the vendor’s pages — a telehealth practice using T.O.V.A. is committing to an in-person visit for every test.

Conners CPT 3 Online moved to MHS’s MAC+ web platform after discontinuing USB software [4]. Remote administration is available for the standalone CPT 3, but not for the K-CPT 2 (ages 4–7) or the CATA auditory/visual attention test, which MHS’s materials describe as local-administration only [4]. MHS states its validation work “supports continued use of existing in-person norms” for the online suite [5]; the underlying study is described in the product manual rather than the public blog post, so request it before relying on that equivalence claim.

QbCheck runs on the patient’s own laptop webcam rather than dedicated hardware. Qbtech’s FAQ specifies a Mac or Windows laptop with a built-in webcam and an Intel Core i5 processor or better, and states plainly that “smartphones, Chromebooks, Surface and Tablets are not compatible” [8]. QbCheck is the remote sibling of the in-clinic QbTest system; for how those two differ, see our QbTest vs. QbCheck comparison.

IVA-2 is unusual here in offering both visual and auditory stimuli in one integrated test. It’s licensed software (a 3-year license per computer) rather than a per-test purchase, requires Windows 11 for the core kit, and remote administration is a separate $695 add-on that still requires the examiner to observe the patient throughout the session by audio/video [9][10].

Test length ranges from about 13 minutes (IVA-2) to nearly 22 minutes (T.O.V.A.) [1][4][8][11]. For preschoolers, T.O.V.A.’s 10.8-minute visual test for ages 4–5.5 is the youngest published option here [2]. For an auditory modality specifically, T.O.V.A. (ages 6–29) and IVA-2 (ages 6–96) publish one; QbCheck and Conners CPT 3 are visual/motor tasks only [2][11].

What does the research say about diagnostic accuracy?

Independent of which product you choose, the evidence on CPTs as a class is consistent: none of them are diagnostic on their own. A 2024 meta-analysis in the Journal of the American Academy of Child & Adolescent Psychiatry pooled 19 studies of commercially available CPTs and found pooled sensitivity of 0.75 and specificity of 0.71 for the overall/ADHD score, concluding that “none of the measures met minimal standards for acceptable sensitivity (0.8) and specificity (0.8)” [14]. A 2024 review of 13 studies on the Conners CPT-3 specifically found most rated it a “weak or poor predictor” of ADHD alone [15], and a separate 2024 review of adult CPT use concluded CPTs “should not be used in isolation as a diagnostic test but may be beneficial when used as a component of a comprehensive assessment” [16]. We cover this evidence base in CPT accuracy for ADHD: what the meta-analyses show.

Every product here, including AxonCPT, supplies one input into a larger evaluation — the interview, history, and rating scales still carry the diagnostic weight. See ADHD rating scales vs. objective testing.

FDA clearance: what it means and who has it

Two of the four named products have documented FDA 510(k) clearances under product code LQD: T.O.V.A. (K170082, K173915) and QbCheck (K143468, cleared as substantially equivalent to the in-clinic QbTest) [13]. We found no openFDA record for Conners CPT 3 Online or IVA-2, and BrainTrain’s remote-testing page for IVA-2 states its products are “not medical devices” and make “no medical claims” [10]. Clearance means the FDA determined the device is substantially equivalent to an existing cleared device; it isn’t a certification of diagnostic accuracy, and cleared and uncleared products carry the same evidence limitations described above.

AxonCPT is not marketed as an FDA-cleared device. It describes itself as objective measurement intended to supplement clinical judgment, not to replace it. If your institution or a specific payer requires a 510(k)-cleared product, T.O.V.A. or QbCheck currently meet that bar among the options here; Conners CPT 3 Online, IVA-2, and AxonCPT do not carry a clearance.

What does each cost?

Only some of these vendors publish clinician-facing prices. Using list prices only, with no tax, shipping, or bulk discounts:

Product Pricing model Illustrative 5-test cost
T.O.V.A. 9 $1,095 system (includes 5 credits) + $15/credit [1] $1,095 (first 5 tests included)
Conners CPT 3 Online $10/use, 15-use minimum ($150) [4] $50 (drawn from the $150 minimum order)
QbCheck From $68/test, invoiced upfront [6] From $340
IVA-2 Standard kit $975 (includes 5 tests, 5 reports) [9] $975 (first 5 tests included)
AxonCPT Free: 2 tests/month; $49/5-test pack; $149/20; $79/mo unlimited [12] $49 (one 5-test pack), or $0 on the free tier

These figures cover the test only, not clinician time, interpretation, or a dedicated computer where one is required. For the full cross-vendor breakdown with per-test math at different volumes, see what objective ADHD testing costs clinicians, and for product-specific detail see our TOVA test cost and QbCheck pricing breakdowns.

Try it with your next patient. AxonCPT gives you 2 free tests every month — no card required. Send a link, your patient finishes in ~16 minutes from home, and you get a norm-referenced report instantly. Create your free account →

Where does AxonCPT fit in this comparison?

AxonCPT is a remote, patient-administered CPT. The patient opens an emailed link and completes the test in about 16 minutes on a phone, tablet, or desktop browser, with no app to install and no login [12]. It reports five metrics against age- and sex-matched norms drawn from a 20,000+ reference dataset across 12 cohorts, with a Q1–Q4 vigilance breakdown for comparing performance across visits [12]. It doesn’t measure motor activity (as QbCheck does via webcam), doesn’t offer an auditory modality (as T.O.V.A. and IVA-2 do), and isn’t FDA-cleared. It differs from the field above in device flexibility (no laptop, webcam, or proprietary hardware requirement) and published, low per-test pricing built for repeat testing during titration. See what the report looks like, or see AxonCPT vs. QbCheck for a head-to-head against the closest remote competitor.

How to choose a CPT for your practice

A short checklist, independent of vendor:

  1. Setting. In-office or at home? Only Conners CPT 3 (standalone), QbCheck, IVA-2 (with the add-on), and AxonCPT publish a remote option.
  2. Device. A webcam laptop requirement (QbCheck) or a proprietary USB device (T.O.V.A.) will exclude some patients from remote testing entirely.
  3. Age range and modality. Match the published age range and visual/auditory coverage to your caseload.
  4. Regulatory requirement. Check whether your institution or a payer requires an FDA-cleared product.
  5. Cost per titration course, not just cost per test. A patient in active titration may take the same test 3–5 times, and the pricing model (subscription, credits, or per-use) changes that math significantly.
  6. Billing fit. No product here has a product-specific code. See CPT code for TOVA, Conners CPT 3, and QbCheck.

How this looks in practice

A psychologist building a battery, or a PMHNP adding an objective measure to a telehealth evaluation, works through roughly the same sequence regardless of product: decide the referral question (first evaluation or titration follow-up), match the test to the setting, send or administer it, then interpret the result alongside the interview, history, and rating scales — never alone — and document why you tested and how the result informed the plan.

For a broader telehealth ADHD workflow, see best remote ADHD tests for telehealth practices and remote CPT testing validity.

Frequently asked questions

Which CPT is the most accurate? No head-to-head study directly compares diagnostic accuracy across these products on the same sample, so none can honestly claim to be “most accurate.” Pooled data across commercially available CPTs shows sensitivity around 0.75 and specificity around 0.71, below the 0.80/0.80 threshold researchers consider acceptable for a standalone tool [14].

Which CPT can be done remotely? QbCheck and Conners CPT 3 (standalone, not K-CPT 2 or CATA) both publish remote options, as does AxonCPT. IVA-2 offers remote testing only with a separate paid license and examiner observation. We found no remote option for T.O.V.A. [1][4][6][10].

Is any of these tests FDA-cleared? T.O.V.A. and QbCheck have documented FDA 510(k) clearances (product code LQD). We found no openFDA record for Conners CPT 3 Online, IVA-2, or AxonCPT [13].

Can a CPT diagnose ADHD by itself? No. Every CPT discussed here, cleared or not, is intended to supplement a clinical evaluation, not replace one. See what a continuous performance test measures.

Do any of these vendors publish a specific billing code? No. Code selection depends on how the test was administered and what else was done. See CPT code for TOVA, Conners CPT 3, and QbCheck.

Start testing your patients with AxonCPT

If device requirements or in-office visits are the barrier to routine objective testing in your practice, AxonCPT lets patients test from any phone, tablet, or computer, with published pricing that scales with a titration course rather than a single evaluation. Start with 2 free tests every month, no card required. Create your free AxonCPT account or learn more at axoncpt.com.

References

  1. The TOVA Company. T.O.V.A. Store. Accessed September 27, 2026.
  2. The TOVA Company. How the T.O.V.A. Works. Accessed September 27, 2026.
  3. The TOVA Company. Computer Requirements. Accessed September 27, 2026.
  4. Multi-Health Systems. Conners CPT Online Suite storefront. Accessed September 27, 2026.
  5. Multi-Health Systems. Flexible, Secure, Online: Meet the Conners CPT Online Suite. Updated August 4, 2026.
  6. Qbtech. QbCheck. Accessed September 27, 2026.
  7. Qbtech. QbTest. Accessed September 27, 2026.
  8. Qbtech. QbCheck Frequently Asked Questions (PDF). Accessed September 27, 2026.
  9. BrainTrain. IVA-2 price list. Accessed September 27, 2026.
  10. BrainTrain. IVA-2 remote testing. Accessed September 27, 2026.
  11. BrainTrain. IVA-2. Accessed September 27, 2026.
  12. AxonCPT. axoncpt.com. Accessed September 27, 2026.
  13. U.S. Food and Drug Administration. 510(k) Premarket Notification database (K040894, K122149, K133382, K143468, K170082, K173915), product code LQD. Queried September 27, 2026.
  14. Arrondo G, Mulraney M, Iturmendi-Sabater I, et al. Systematic Review and Meta-Analysis: Clinical Utility of Continuous Performance Tests for the Identification of Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry. 2024;63(2):154-171.
  15. Callan PD, Swanberg S, Weber SK, Eidnes K, Pope TM, Shepler D. Diagnostic Utility of Conners Continuous Performance Test-3 for Attention-Deficit/Hyperactivity Disorder: A Systematic Review. J Atten Disord. 2024;28(6):992-1007.
  16. Varela JL, Magnante AT, Miskey HM, et al. A systematic review of the utility of continuous performance tests among adults with ADHD. Clin Neuropsychol. 2024;38(7):1524-1585.