CPT code 96156: Health behavior assessment, assessment or reassessment2026 Medicare rate & RVUs in Delaware

In Delaware, Medicare pays $107.56 for 96156 in the office and $87.10 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 96156 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 96156 covers

96156 covers a health-focused clinical interview, behavioral observations, and clinical decision-making to assess how a patient's behavior and other personal factors relate to physical health. Physicians and other qualified health professionals may perform it in settings such as primary care or specialty clinics for patients managing conditions such as diabetes, chronic pain, or obesity. The focus is the connection between behavior and physical health, rather than psychotherapy or psychological testing.

Choose the code when the encounter consists of assessment or reassessment, not active behavioral intervention. Document the health condition or concern, relevant behavioral factors, assessment findings, and resulting clinical decisions. The service is not selected in timed increments; elapsed minutes alone do not establish additional units. CMS assigns physician work and practice-expense relative values, with practice-expense inputs differing between office and facility settings.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Delaware compares for 96156

Across 109 of 109 payment localities, the office rate for 96156 runs from $103.46 in Arkansas to $149.07 in Alaska. Delaware pays $107.56. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

96156 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 96156 in every payment locality

How the 96156 rate is calculated

Each of 96156’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 96156

96156 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Codes related to 96156

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 96156 has changed in Delaware

Price 96156 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

• Arden
• Ardencroft
• Ardentown
• Bear
• Bellefonte
• Bethany Beach
• Bethel
• Blades

Browse all communities in Delaware

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates