CPT code 96160: Health risk assessment, patient-focused instrument2026 Medicare rate & RVUs in Mississippi

Report this service for administering and documenting a standardized instrument that assesses a patient’s health risks, alongside a qualifying primary procedure.

CMS RVU26DEffective Oct 1, 2026One payment locality214.3K Medicare services in 2024

In Mississippi, Medicare pays $2.59 for 96160 in the office.

$2.59Office (non-facility)
Not available in this settingHospital or facility
−14.0%vs the national office rate ($3.01)

Check a contract rate as a % of Medicare · 96160 nationwide

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

We’ll open 96160 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Mississippi
  2. What 96160 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 96160 covers

This service covers a standardized instrument focused on the patient’s health risks, such as a health hazard appraisal, including the instrument’s scoring and documentation. The patient may complete the questions during a physician-office encounter, with practice staff administering or scoring the instrument under physician supervision when the service is billed incident-to.

Select this code when the documented service is a patient-focused risk instrument, rather than a clinician’s broader health behavior assessment or a brief emotional or behavioral screen. Keep the instrument, score, and resulting documentation in the record. CMS treats the code as an add-on: report it only with a primary procedure, and payment falls within that procedure’s global period. CMS assigns zero work and malpractice RVUs, with practice-expense RVUs in both 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 Mississippi compares for 96160

Across 109 of 109 payment localities, the office rate for 96160 runs from $2.58 in Arkansas to $4.33 in Santa Clara County, CA. Mississippi pays $2.59. The RVUs are the same everywhere; the geographic indexes change the dollars.

96160 in Mississippi vs other payment areas
  1. Mississippi · this page$2.59
  2. Los Angeles, CA · California$3.56+$0.97
  3. Washington, DC area · District of Columbia$3.54+$0.95
  4. Miami, FL · Florida$3.13+$0.54
  5. Chicago, IL · Illinois$3.02+$0.43
  6. Manhattan, NY · New York$3.49+$0.90
  7. Alaska · Alaska$3.20+$0.61

Other areas in Mississippi first, then benchmark localities. Bars start at $0.

Every other payment area

96160 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$2.63—
ArkansasArkansas$2.58—
ArizonaArizona$2.91—
Bakersfield, CACalifornia$3.29—
Chico, CACalifornia$3.29—
El Centro, CACalifornia$3.29—
Fresno, CACalifornia$3.29—
Hanford, CACalifornia$3.29—

96160 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.

$2.58

$3.81

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
96160 office rate range by state
State / territoryOffice rate rangeLocalities
AK$3.201
AL$2.631
AR$2.581
AZ$2.911
CA$3.29–$4.3329
CO$3.201
CT$3.241
DC$3.541
DE$2.971
FL$2.87–$3.133
GA$2.68–$3.052
GU$3.421
HI$3.421
IA$2.751
ID$2.771
IL$2.74–$3.094
IN$2.791
KS$2.721
KY$2.671
LA$2.66–$2.832
MA$3.17–$3.592
MD$3.04–$3.543
ME$2.77–$2.982
MI$2.74–$2.902
MN$3.091
MO$2.59–$2.863
MS$2.591
MT$3.011
NC$2.801
ND$3.011
NE$2.771
NH$3.131
NJ$3.28–$3.492
NM$2.761
NV$3.011
NY$2.86–$3.575
OH$2.741
OK$2.681
OR$2.99–$3.342
PA$2.76–$3.132
PR$3.041
RI$3.111
SC$2.781
SD$3.011
TN$2.731
TX$2.74–$3.188
UT$2.831
VA$2.95–$3.542
VI$3.041
VT$2.981
WA$3.17–$3.692
WI$2.881
WV$2.611
WY$3.011

See 96160 in every payment locality

How the 96160 rate is calculated

Each of 96160’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 · 96160

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.09

0.09 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0900

Conversion factor

$33.4009

Medicare rate

$3.01

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Mississippi inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,767

Code
96160
Physician work
0.00
Practice expense
0.09
Malpractice
0.00

GPCI2026.csv

67

Locality
Mississippi
Physician work
1.000
Practice expense
0.861
Malpractice
0.739
Office calculation for 96160 in Mississippi
ComponentRVULocality factorAdjusted
Physician work0.00× 1.0000.0000
Practice expense0.09× 0.8610.0775
Malpractice0.00× 0.7390.0000
Total RVUs0.0775
Conversion factor× 33.4009

Office rate, Mississippi$2.59

Office: (0 × 1 + 0.09 × 0.861 + 0 × 0.739) × $33.4009 = $2.59

Open 96160 in the RVU calculator

Payment rules and modifiers for 96160

The CMS indicators that decide how 96160 is paid alongside other services.

CMS payment indicators · 96160

Health risk assessment, patient-focused instrument

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures9The concept doesn’t apply.
Bilateral (modifier 50)9The concept doesn’t apply.
Assistant at surgery (80/81/82/AS)9The concept doesn’t apply.
Co-surgeons (62)9The concept doesn’t apply.
Team surgery (66)9The concept doesn’t apply.
Professional/technical5Incident-to service.

How 96160 has changed in Mississippi

96160 · Office / nonfacility

$2.59

Effective 2026-10-01

The base rate is $0.11 higher than on 2025-10-01, moving from $2.48 to $2.59 (4.4%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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
  1. January 1, 2026

    RVU26A

    $2.48changed to$2.59

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense GPCI 0.852 changed to 0.861
    • Malpractice GPCI 0.768 changed to 0.739

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $2.55changed to$2.48

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $2.51changed to$2.55

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $2.30changed to$2.51

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.08 changed to 0.09
    • Practice expense GPCI 0.847 changed to 0.852
    • Malpractice GPCI 0.720 changed to 0.768
  5. January 1, 2023

    RVU23A

    $2.33changed to$2.30

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense GPCI 0.842 changed to 0.847
    • Malpractice GPCI 0.671 changed to 0.720

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $2.35changed to$2.33

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $2.16changed to$2.35

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.07 changed to 0.08
    • Practice expense GPCI 0.856 changed to 0.842
    • Malpractice GPCI 0.521 changed to 0.671

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $2.82changed to$2.16

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.09 changed to 0.07
    • Practice expense GPCI 0.870 changed to 0.856
    • Malpractice GPCI 0.370 changed to 0.521

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $3.45changed to$2.82

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.11 changed to 0.09

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $4.05changed to$3.45

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.13 changed to 0.11
    • Practice expense GPCI 0.867 changed to 0.870
    • Malpractice GPCI 0.492 changed to 0.370

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$4.05

    Held through RVU17B, RVU17C, RVU17D.

  12. 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.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$2.59Not available in this settingRVU26D
2026-07-01$2.59Not available in this settingRVU26C
2026-04-01$2.59Not available in this settingRVU26B
2026-01-01$2.59Not available in this settingRVU26A
2025-10-01$2.48Not available in this settingRVU25D
2025-07-01$2.48Not available in this settingRVU25C
2025-04-01$2.48Not available in this settingRVU25B
2025-01-01$2.48Not available in this settingRVU25A
2024-10-01$2.55Not available in this settingRVU24D
2024-07-01$2.55Not available in this settingRVU24C
2024-04-01$2.55Not available in this settingRVU24B
2024-03-09$2.55Not available in this settingRVU24AR
2024-01-01$2.51Not available in this settingRVU24A
2023-10-01$2.30Not available in this settingRVU23D
2023-07-01$2.30Not available in this settingRVU23C
2023-04-01$2.30Not available in this settingRVU23B
2023-01-01$2.30Not available in this settingRVU23A
2022-10-01$2.33Not available in this settingRVU22D
2022-07-01$2.33Not available in this settingRVU22C
2022-04-01$2.33Not available in this settingRVU22B
2022-01-01$2.33Not available in this settingRVU22A
2021-10-01$2.35Not available in this settingRVU21D
2021-07-01$2.35Not available in this settingRVU21C
2021-04-01$2.35Not available in this settingRVU21B
2021-01-01$2.35Not available in this settingRVU21A
2020-10-01$2.16Not available in this settingRVU20D
2020-07-01$2.16Not available in this settingRVU20C
2020-04-01$2.16Not available in this settingRVU20B
2020-01-01$2.16Not available in this settingRVU20A
2019-10-01$2.82Not available in this settingRVU19D
2019-07-01$2.82Not available in this settingRVU19C
2019-04-01$2.82Not available in this settingRVU19B
2019-01-01$2.82Not available in this settingRVU19A
2018-10-01$3.45Not available in this settingRVU18D
2018-07-01$3.45Not available in this settingRVU18C
2018-04-01$3.45Not available in this settingRVU18B
2018-01-01$3.45Not available in this settingRVU18AR1
2017-10-01$4.05Not available in this settingRVU17D
2017-07-01$4.05Not available in this settingRVU17C
2017-04-01$4.05Not available in this settingRVU17B
2017-01-01$4.05Not available in this settingRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 96160 for an earlier date of service

Where the Mississippi rate applies

Mississippi is a Medicare payment area, not a city. Our Census mapping connects it to 427 cities and communities in Mississippi. Some span more than one payment area; confirm with the service ZIP.

  • Abbeville
  • Aberdeen
  • Ackerman
  • Agricola
  • Alcorn State University
  • Algoma
  • Alligator
  • Amory

Browse all communities in Mississippi

96160 billing questions

Can 96160 be billed by itself?

No. CMS identifies it as an add-on code, so the claim must include a primary procedure; payment falls within that procedure’s global period.

What documentation supports 96160?

Document the standardized patient-focused risk instrument, its administration, the score, and the resulting assessment information.

Can practice staff administer or score the instrument?

The service may be billed incident-to only when performed under physician supervision.

How is 96160 different from 96127?

96160 concerns a patient-focused health risk instrument. 96127 is for a brief emotional or behavioral assessment.

Is 96160 interchangeable with a caregiver risk assessment?

No. 96160 is focused on the patient; 96161 is the related code for a caregiver-focused health risk assessment.

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
RVUs for 96160PPRRVU2026_Oct_nonQPP.csv, line 12,767 (RVU26D)
Geographic factors for MississippiGPCI2026.csv, line 67 (RVU26D)

Open CMS sourceHow we calculate rates

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