CPT code 96156: Health behavior assessment, assessment or reassessment2026 Medicare rate & RVUs in Montana
Report 96156 for a health-focused assessment of behavioral factors affecting a patient's physical condition, treatment adherence, or health outcomes.
In Montana, Medicare pays $107.55 for 96156 in the office and $86.84 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.
On this page 11 sections
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 Montana 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. Montana pays $107.55. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$107.55
- Los Angeles, CA · California$115.50+$7.95
- Washington, DC area · District of Columbia$116.71+$9.16
- Miami, FL · Florida$109.67+$2.12
- Chicago, IL · Illinois$109.11+$1.56
- Manhattan, NY · New York$117.40+$9.85
- Alaska · Alaska$149.07+$41.52
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $103.92 | $85.80 |
| ArkansasArkansas | $103.46 | $85.67 |
| ArizonaArizona | $106.63 | $86.56 |
| Bakersfield, CACalifornia | $111.38 | $88.68 |
| Chico, CACalifornia | $111.17 | $88.47 |
| El Centro, CACalifornia | $111.17 | $88.48 |
| Fresno, CACalifornia | $111.17 | $88.47 |
| Hanford, CACalifornia | $111.17 | $88.47 |
| Madera, CACalifornia | $111.17 | $88.47 |
| Merced, CACalifornia | $111.17 | $88.47 |
| Modesto, CACalifornia | $111.17 | $88.47 |
| Napa, CACalifornia | $120.77 | $93.48 |
| Oxnard, CACalifornia | $114.41 | $89.93 |
| Redding, CACalifornia | $111.17 | $88.47 |
| Rest of CaliforniaCalifornia | $111.17 | $88.47 |
| Riverside, CACalifornia | $111.46 | $88.76 |
| Sacramento, CACalifornia | $114.48 | $90.40 |
| Salinas, CACalifornia | $113.97 | $89.97 |
| San Diego, CACalifornia | $114.89 | $90.12 |
| Marin County, CACalifornia | $125.76 | $96.56 |
| San Francisco, CACalifornia | $125.74 | $96.54 |
| San Benito County, CACalifornia | $127.87 | $98.01 |
| Santa Clara County, CACalifornia | $127.78 | $97.91 |
| San Luis Obispo, CACalifornia | $112.32 | $88.73 |
| Santa Cruz, CACalifornia | $114.67 | $89.51 |
| Santa Maria, CACalifornia | $113.92 | $89.77 |
| Santa Rosa, CACalifornia | $115.74 | $90.31 |
| Stockton, CACalifornia | $111.17 | $88.47 |
| Vallejo, CACalifornia | $120.74 | $93.44 |
| Visalia, CACalifornia | $111.17 | $88.47 |
| Yuba City, CACalifornia | $111.17 | $88.47 |
| ColoradoColorado | $110.08 | $88.04 |
| ConnecticutConnecticut | $111.35 | $89.05 |
| DelawareDelaware | $107.56 | $87.10 |
| Fort Lauderdale, FLFlorida | $108.44 | $87.46 |
| Rest of FloridaFlorida | $106.71 | $86.91 |
| Atlanta, GAGeorgia | $108.35 | $87.31 |
| Rest of GeorgiaGeorgia | $104.79 | $86.32 |
| Hawaii, Guam, HIHawaii | $110.93 | $87.38 |
| IowaIowa | $104.88 | $85.93 |
| IdahoIdaho | $105.06 | $86.01 |
| East St. Louis, ILIllinois | $106.09 | $87.04 |
| Rest of IllinoisIllinois | $105.60 | $86.70 |
| Suburban Chicago, ILIllinois | $109.35 | $88.08 |
| IndianaIndiana | $105.26 | $86.06 |
| KansasKansas | $104.65 | $85.93 |
| KentuckyKentucky | $104.53 | $86.12 |
| New Orleans, LALouisiana | $106.07 | $86.58 |
| Rest of LouisianaLouisiana | $104.45 | $86.12 |
| Metropolitan Boston, MAMassachusetts | $115.95 | $91.22 |
| Rest of MassachusettsMassachusetts | $110.11 | $88.31 |
| Baltimore area, MDMaryland | $110.94 | $88.72 |
| Rest of MarylandMaryland | $108.62 | $87.66 |
| Rest of MaineMaine | $105.16 | $86.11 |
| Southern Maine, MEMaine | $107.06 | $86.54 |
| Detroit, MIMichigan | $107.07 | $87.09 |
| Rest of MichiganMichigan | $105.31 | $86.41 |
| MinnesotaMinnesota | $107.86 | $86.55 |
| Metropolitan Kansas City, MOMissouri | $105.91 | $86.46 |
| Metropolitan St. Louis, MOMissouri | $106.27 | $86.56 |
| Rest of MissouriMissouri | $103.85 | $86.00 |
| MississippiMississippi | $103.66 | $85.83 |
| North CarolinaNorth Carolina | $105.52 | $86.20 |
| North DakotaNorth Dakota | $107.15 | $86.45 |
| NebraskaNebraska | $105.08 | $85.96 |
| New HampshireNew Hampshire | $108.56 | $87.01 |
| Northern New JerseyNew Jersey | $116.92 | $92.90 |
| Rest of New JerseyNew Jersey | $113.28 | $90.67 |
| New MexicoNew Mexico | $105.47 | $86.48 |
| NevadaNevada | $107.47 | $86.74 |
| NYC suburbs and Long Island, NYNew York | $118.30 | $93.68 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $113.84 | $91.16 |
| Queens, NYNew York | $117.84 | $93.36 |
| Rest of New YorkNew York | $106.02 | $86.34 |
| OhioOhio | $105.23 | $86.32 |
| OklahomaOklahoma | $104.54 | $86.05 |
| Portland, OROregon | $111.63 | $88.62 |
| Rest of OregonOregon | $107.25 | $86.62 |
| Metropolitan Philadelphia, PAPennsylvania | $110.22 | $88.66 |
| Rest of PennsylvaniaPennsylvania | $105.32 | $86.31 |
| Puerto RicoPuerto Rico | $107.83 | $86.90 |
| Rhode IslandRhode Island | $109.88 | $88.49 |
| South CarolinaSouth Carolina | $105.42 | $86.29 |
| South DakotaSouth Dakota | $107.11 | $86.40 |
| TennesseeTennessee | $104.81 | $85.99 |
| Austin, TXTexas | $109.18 | $87.28 |
| Beaumont, TXTexas | $105.10 | $86.25 |
| Brazoria, TXTexas | $107.80 | $87.28 |
| Dallas, TXTexas | $108.07 | $87.44 |
| Fort Worth, TXTexas | $107.81 | $87.39 |
| Galveston, TXTexas | $107.89 | $87.33 |
| Houston, TXTexas | $108.26 | $87.69 |
| Rest of TexasTexas | $106.12 | $86.47 |
| UtahUtah | $105.88 | $86.41 |
| VirginiaVirginia | $106.90 | $86.54 |
| Virgin Islands, VIUnited States Virgin Islands | $107.83 | $86.90 |
| VermontVermont | $106.95 | $86.45 |
| Rest of WashingtonWashington | $109.85 | $88.04 |
| King County, WAWashington | $117.50 | $92.09 |
| WisconsinWisconsin | $105.97 | $86.13 |
| West VirginiaWest Virginia | $104.34 | $86.34 |
| WyomingWyoming | $107.38 | $86.67 |
96156 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$103.46
$149.07
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $149.07 | 1 |
| AL | $103.92 | 1 |
| AR | $103.46 | 1 |
| AZ | $106.63 | 1 |
| CA | $111.17–$127.87 | 29 |
| CO | $110.08 | 1 |
| CT | $111.35 | 1 |
| DC | $116.71 | 1 |
| DE | $107.56 | 1 |
| FL | $106.71–$109.67 | 3 |
| GA | $104.79–$108.35 | 2 |
| GU | $110.93 | 1 |
| HI | $110.93 | 1 |
| IA | $104.88 | 1 |
| ID | $105.06 | 1 |
| IL | $105.60–$109.35 | 4 |
| IN | $105.26 | 1 |
| KS | $104.65 | 1 |
| KY | $104.53 | 1 |
| LA | $104.45–$106.07 | 2 |
| MA | $110.11–$115.95 | 2 |
| MD | $108.62–$116.71 | 3 |
| ME | $105.16–$107.06 | 2 |
| MI | $105.31–$107.07 | 2 |
| MN | $107.86 | 1 |
| MO | $103.85–$106.27 | 3 |
| MS | $103.66 | 1 |
| MT | $107.55 | 1 |
| NC | $105.52 | 1 |
| ND | $107.15 | 1 |
| NE | $105.08 | 1 |
| NH | $108.56 | 1 |
| NJ | $113.28–$116.92 | 2 |
| NM | $105.47 | 1 |
| NV | $107.47 | 1 |
| NY | $106.02–$118.30 | 5 |
| OH | $105.23 | 1 |
| OK | $104.54 | 1 |
| OR | $107.25–$111.63 | 2 |
| PA | $105.32–$110.22 | 2 |
| PR | $107.83 | 1 |
| RI | $109.88 | 1 |
| SC | $105.42 | 1 |
| SD | $107.11 | 1 |
| TN | $104.81 | 1 |
| TX | $105.10–$109.18 | 8 |
| UT | $105.88 | 1 |
| VA | $106.90–$116.71 | 2 |
| VI | $107.83 | 1 |
| VT | $106.95 | 1 |
| WA | $109.85–$117.50 | 2 |
| WI | $105.97 | 1 |
| WV | $104.34 | 1 |
| WY | $107.38 | 1 |
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.
How the rate is built · 96156
RVUs × geographic indexes × conversion factor
Work2.40
2.40 RVUs× 1.000 GPCI
Practice expense0.80
0.80 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
3.2200
Conversion factor
$33.4009
Medicare rate
$107.55
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Montana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,764
- Code
- 96156
- Physician work
- 2.40
- Practice expense
- 0.80
- Malpractice
- 0.02
GPCI2026.csv
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.40 | × 1.000 | 2.4000 |
| Practice expense | 0.80 | × 1.000 | 0.8000 |
| Malpractice | 0.02 | × 0.998 | 0.0200 |
| Total RVUs | 3.2200 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Montana$107.55
Office: (2.4 × 1 + 0.8 × 1 + 0.02 × 0.998) × $33.4009 = $107.55
Facility: (2.4 × 1 + 0.18 × 1 + 0.02 × 0.998) × $33.4009 = $86.84
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.
Place of service · 96156
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$107.55
- Non-facility (office)
- $107.55
- Facility
- $86.84
Higher because the practice carries its own overhead.
How 96156 has changed in Montana
96156 · Office / nonfacility
$107.55
Effective 2026-10-01
The base rate is $8.61 higher than on 2025-10-01, moving from $98.94 to $107.55 (8.7%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$98.94changed to$107.55
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 2.30 changed to 2.40
- Practice expense RVU 0.70 changed to 0.80
- Malpractice RVU 0.06 changed to 0.02
- Malpractice GPCI 0.978 changed to 0.998
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$98.81changed to$98.94
- Conversion factor 33.2875 changed to 32.3465
- Work RVU 2.20 changed to 2.30
- Malpractice RVU 0.07 changed to 0.06
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$97.20changed to$98.81
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$95.18changed to$97.20
- Conversion factor 33.8872 changed to 32.7442
- Work RVU 2.10 changed to 2.20
- Practice expense RVU 0.65 changed to 0.70
- Malpractice RVU 0.06 changed to 0.07
January 1, 2023
RVU23A
$97.52changed to$95.18
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.63 changed to 0.65
- Malpractice RVU 0.09 changed to 0.06
- Malpractice GPCI 0.977 changed to 0.978
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$97.28changed to$97.52
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.60 changed to 0.63
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$100.96changed to$97.28
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.58 changed to 0.60
- Malpractice GPCI 1.304 changed to 0.977
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
No ratechanged to$100.96
Held through RVU20B, RVU20C, RVU20D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $107.55 | $86.84 | RVU26D |
| 2026-07-01 | $107.55 | $86.84 | RVU26C |
| 2026-04-01 | $107.55 | $86.84 | RVU26B |
| 2026-01-01 | $107.55 | $86.84 | RVU26A |
| 2025-10-01 | $98.94 | $86.65 | RVU25D |
| 2025-07-01 | $98.94 | $86.65 | RVU25C |
| 2025-04-01 | $98.94 | $86.65 | RVU25B |
| 2025-01-01 | $98.94 | $86.65 | RVU25A |
| 2024-10-01 | $98.81 | $87.49 | RVU24D |
| 2024-07-01 | $98.81 | $87.49 | RVU24C |
| 2024-04-01 | $98.81 | $87.49 | RVU24B |
| 2024-03-09 | $98.81 | $87.49 | RVU24AR |
| 2024-01-01 | $97.20 | $86.07 | RVU24A |
| 2023-10-01 | $95.18 | $84.33 | RVU23D |
| 2023-07-01 | $95.18 | $84.33 | RVU23C |
| 2023-04-01 | $95.18 | $84.33 | RVU23B |
| 2023-01-01 | $95.18 | $84.33 | RVU23A |
| 2022-10-01 | $97.52 | $86.79 | RVU22D |
| 2022-07-01 | $97.52 | $86.79 | RVU22C |
| 2022-04-01 | $97.52 | $86.79 | RVU22B |
| 2022-01-01 | $97.52 | $86.79 | RVU22A |
| 2021-10-01 | $97.28 | $86.11 | RVU21D |
| 2021-07-01 | $97.28 | $86.11 | RVU21C |
| 2021-04-01 | $97.28 | $86.11 | RVU21B |
| 2021-01-01 | $97.28 | $86.11 | RVU21A |
| 2020-10-01 | $100.96 | $91.57 | RVU20D |
| 2020-07-01 | $100.96 | $91.57 | RVU20C |
| 2020-04-01 | $100.96 | $91.57 | RVU20B |
| 2020-01-01 | $100.96 | $91.57 | RVU20A |
| 2019-10-01 | Not in this release | Not in this release | RVU19D |
| 2019-07-01 | Not in this release | Not in this release | RVU19C |
| 2019-04-01 | Not in this release | Not in this release | RVU19B |
| 2019-01-01 | Not in this release | Not in this release | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
96156 billing questions
How is 96156 different from 96158?
96156 represents assessment or reassessment of behavioral factors affecting physical health. 96158 represents individual health behavior intervention, such as working with the patient on behavioral changes.
Can 96156 be billed in timed units?
No timed increments are specified for 96156. Document the assessment performed rather than deriving units from elapsed minutes.
What should the record support?
Document the physical health concern, the behavioral factors assessed, relevant observations or interview findings, and the clinical decisions resulting from the assessment.
When is 96127 a better fit?
Use 96127 for a brief emotional or behavioral assessment. Use 96156 when the service is a broader health-focused assessment of behavioral factors related to physical health.
Is a patient health-risk questionnaire the same service?
No. 96160 represents a patient-focused health risk assessment; 96156 involves health-focused clinical interviewing, behavioral observation, and clinical decision-making.
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
Show the CMS file lines behind this rate
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