CPT code 96164: Group intervention, first 30 minutes2026 Medicare rate & RVUs in Nevada
Report 96164 for the initial 30 minutes of face-to-face group intervention addressing behavioral factors that affect patients’ physical health or treatment.
In Nevada, Medicare pays $11.64 for 96164 in the office and $9.30 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 96164 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 96164 covers
Code 96164 represents face-to-face health behavior intervention delivered to a group of at least two patients. A physician or other qualified health care professional works with the group on behavioral, psychological, social, or lifestyle factors affecting physical health or adherence to medical treatment. For example, patients with a chronic condition may receive group support for barriers to following a treatment plan. This is an intervention, not simply a group screening or assessment.
Report 96164 for the initial 30 minutes of the group service. The record should identify the health-related behavioral needs addressed, the intervention provided, the participants, and the time spent. Use 96165 for qualifying additional time. CMS fee-schedule valuation includes physician work, practice expense, and malpractice; the practice-expense value differs 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 Nevada compares for 96164
Across 109 of 109 payment localities, the office rate for 96164 runs from $11.06 in Arkansas to $15.77 in Alaska. Nevada pays $11.64. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Nevada · this page$11.64
- Los Angeles, CA · California$12.52+$0.88
- Washington, DC area · District of Columbia$12.76+$1.12
- Miami, FL · Florida$12.34+$0.70
- Chicago, IL · Illinois$12.20+$0.56
- Manhattan, NY · New York$12.94+$1.30
- Alaska · Alaska$15.77+$4.13
Other areas in Nevada first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $11.13 | $9.08 |
| ArkansasArkansas | $11.06 | $9.05 |
| ArizonaArizona | $11.54 | $9.27 |
| Bakersfield, CACalifornia | $12.03 | $9.47 |
| Chico, CACalifornia | $11.99 | $9.43 |
| El Centro, CACalifornia | $11.99 | $9.43 |
| Fresno, CACalifornia | $11.99 | $9.43 |
| Hanford, CACalifornia | $11.99 | $9.43 |
| Madera, CACalifornia | $11.99 | $9.43 |
| Merced, CACalifornia | $11.99 | $9.43 |
| Modesto, CACalifornia | $11.99 | $9.43 |
| Napa, CACalifornia | $13.09 | $10.01 |
| Oxnard, CACalifornia | $12.40 | $9.63 |
| Redding, CACalifornia | $11.99 | $9.43 |
| Rest of CaliforniaCalifornia | $11.99 | $9.43 |
| Riverside, CACalifornia | $12.11 | $9.54 |
| Sacramento, CACalifornia | $12.37 | $9.65 |
| Salinas, CACalifornia | $12.31 | $9.61 |
| San Diego, CACalifornia | $12.43 | $9.64 |
| Marin County, CACalifornia | $13.64 | $10.34 |
| San Francisco, CACalifornia | $13.63 | $10.33 |
| San Benito County, CACalifornia | $13.89 | $10.52 |
| Santa Clara County, CACalifornia | $13.85 | $10.48 |
| San Luis Obispo, CACalifornia | $12.14 | $9.47 |
| Santa Cruz, CACalifornia | $12.42 | $9.58 |
| Santa Maria, CACalifornia | $12.31 | $9.59 |
| Santa Rosa, CACalifornia | $12.54 | $9.67 |
| Stockton, CACalifornia | $11.99 | $9.43 |
| Vallejo, CACalifornia | $13.08 | $10.00 |
| Visalia, CACalifornia | $11.99 | $9.43 |
| Yuba City, CACalifornia | $11.99 | $9.43 |
| ColoradoColorado | $11.93 | $9.44 |
| ConnecticutConnecticut | $12.18 | $9.66 |
| DelawareDelaware | $11.66 | $9.35 |
| Fort Lauderdale, FLFlorida | $12.00 | $9.64 |
| Rest of FloridaFlorida | $11.71 | $9.48 |
| Atlanta, GAGeorgia | $11.83 | $9.46 |
| Rest of GeorgiaGeorgia | $11.39 | $9.31 |
| Hawaii, Guam, HIHawaii | $12.01 | $9.35 |
| IowaIowa | $11.20 | $9.07 |
| IdahoIdaho | $11.25 | $9.10 |
| East St. Louis, ILIllinois | $11.76 | $9.61 |
| Rest of IllinoisIllinois | $11.59 | $9.45 |
| Suburban Chicago, ILIllinois | $12.09 | $9.69 |
| IndianaIndiana | $11.27 | $9.11 |
| KansasKansas | $11.20 | $9.09 |
| KentuckyKentucky | $11.29 | $9.21 |
| New Orleans, LALouisiana | $11.54 | $9.34 |
| Rest of LouisianaLouisiana | $11.29 | $9.22 |
| Metropolitan Boston, MAMassachusetts | $12.63 | $9.84 |
| Rest of MassachusettsMassachusetts | $11.93 | $9.47 |
| Baltimore area, MDMaryland | $12.14 | $9.63 |
| Rest of MarylandMaryland | $11.78 | $9.42 |
| Rest of MaineMaine | $11.30 | $9.15 |
| Southern Maine, MEMaine | $11.54 | $9.22 |
| Detroit, MIMichigan | $11.80 | $9.55 |
| Rest of MichiganMichigan | $11.44 | $9.31 |
| MinnesotaMinnesota | $11.55 | $9.15 |
| Metropolitan Kansas City, MOMissouri | $11.48 | $9.28 |
| Metropolitan St. Louis, MOMissouri | $11.53 | $9.30 |
| Rest of MissouriMissouri | $11.22 | $9.21 |
| MississippiMississippi | $11.14 | $9.13 |
| MontanaMontana | $11.69 | $9.35 |
| North CarolinaNorth Carolina | $11.35 | $9.16 |
| North DakotaNorth Dakota | $11.49 | $9.15 |
| NebraskaNebraska | $11.23 | $9.07 |
| New HampshireNew Hampshire | $11.79 | $9.35 |
| Northern New JerseyNew Jersey | $12.75 | $10.04 |
| Rest of New JerseyNew Jersey | $12.35 | $9.80 |
| New MexicoNew Mexico | $11.48 | $9.34 |
| NYC suburbs and Long Island, NYNew York | $13.12 | $10.34 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $12.44 | $9.88 |
| Queens, NYNew York | $12.96 | $10.20 |
| Rest of New YorkNew York | $11.42 | $9.20 |
| OhioOhio | $11.40 | $9.27 |
| OklahomaOklahoma | $11.26 | $9.17 |
| Portland, OROregon | $12.10 | $9.51 |
| Rest of OregonOregon | $11.58 | $9.25 |
| Metropolitan Philadelphia, PAPennsylvania | $12.04 | $9.60 |
| Rest of PennsylvaniaPennsylvania | $11.40 | $9.25 |
| Puerto RicoPuerto Rico | $11.72 | $9.36 |
| Rhode IslandRhode Island | $11.92 | $9.50 |
| South CarolinaSouth Carolina | $11.39 | $9.23 |
| South DakotaSouth Dakota | $11.47 | $9.13 |
| TennesseeTennessee | $11.23 | $9.11 |
| Austin, TXTexas | $11.86 | $9.39 |
| Beaumont, TXTexas | $11.37 | $9.24 |
| Brazoria, TXTexas | $11.65 | $9.33 |
| Dallas, TXTexas | $11.70 | $9.37 |
| Fort Worth, TXTexas | $11.67 | $9.37 |
| Galveston, TXTexas | $11.67 | $9.35 |
| Houston, TXTexas | $11.86 | $9.53 |
| Rest of TexasTexas | $11.49 | $9.27 |
| UtahUtah | $11.46 | $9.26 |
| VirginiaVirginia | $11.54 | $9.24 |
| Virgin Islands, VIUnited States Virgin Islands | $11.72 | $9.36 |
| VermontVermont | $11.49 | $9.18 |
| Rest of WashingtonWashington | $11.89 | $9.43 |
| King County, WAWashington | $12.79 | $9.92 |
| WisconsinWisconsin | $11.32 | $9.08 |
| West VirginiaWest Virginia | $11.40 | $9.36 |
| WyomingWyoming | $11.60 | $9.27 |
96164 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.
$11.06
$15.77
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 | $15.77 | 1 |
| AL | $11.13 | 1 |
| AR | $11.06 | 1 |
| AZ | $11.54 | 1 |
| CA | $11.99–$13.89 | 29 |
| CO | $11.93 | 1 |
| CT | $12.18 | 1 |
| DC | $12.76 | 1 |
| DE | $11.66 | 1 |
| FL | $11.71–$12.34 | 3 |
| GA | $11.39–$11.83 | 2 |
| GU | $12.01 | 1 |
| HI | $12.01 | 1 |
| IA | $11.20 | 1 |
| ID | $11.25 | 1 |
| IL | $11.59–$12.20 | 4 |
| IN | $11.27 | 1 |
| KS | $11.20 | 1 |
| KY | $11.29 | 1 |
| LA | $11.29–$11.54 | 2 |
| MA | $11.93–$12.63 | 2 |
| MD | $11.78–$12.76 | 3 |
| ME | $11.30–$11.54 | 2 |
| MI | $11.44–$11.80 | 2 |
| MN | $11.55 | 1 |
| MO | $11.22–$11.53 | 3 |
| MS | $11.14 | 1 |
| MT | $11.69 | 1 |
| NC | $11.35 | 1 |
| ND | $11.49 | 1 |
| NE | $11.23 | 1 |
| NH | $11.79 | 1 |
| NJ | $12.35–$12.75 | 2 |
| NM | $11.48 | 1 |
| NV | $11.64 | 1 |
| NY | $11.42–$13.12 | 5 |
| OH | $11.40 | 1 |
| OK | $11.26 | 1 |
| OR | $11.58–$12.10 | 2 |
| PA | $11.40–$12.04 | 2 |
| PR | $11.72 | 1 |
| RI | $11.92 | 1 |
| SC | $11.39 | 1 |
| SD | $11.47 | 1 |
| TN | $11.23 | 1 |
| TX | $11.37–$11.86 | 8 |
| UT | $11.46 | 1 |
| VA | $11.54–$12.76 | 2 |
| VI | $11.72 | 1 |
| VT | $11.49 | 1 |
| WA | $11.89–$12.79 | 2 |
| WI | $11.32 | 1 |
| WV | $11.40 | 1 |
| WY | $11.60 | 1 |
How the 96164 rate is calculated
Each of 96164’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 · 96164
RVUs × geographic indexes × conversion factor
Work0.24
0.24 RVUs× 1.000 GPCI
Practice expense0.10
0.10 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.3500
Conversion factor
$33.4009
Medicare rate
$11.69
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Nevada inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,769
- Code
- 96164
- Physician work
- 0.24
- Practice expense
- 0.10
- Malpractice
- 0.01
GPCI2026.csv
73
- Locality
- Nevada
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.24 | × 1.000 | 0.2400 |
| Practice expense | 0.10 | × 1.001 | 0.1001 |
| Malpractice | 0.01 | × 0.833 | 0.0083 |
| Total RVUs | 0.3484 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Nevada$11.64
Office: (0.24 × 1 + 0.1 × 1.001 + 0.01 × 0.833) × $33.4009 = $11.64
Facility: (0.24 × 1 + 0.03 × 1.001 + 0.01 × 0.833) × $33.4009 = $9.30
Payment rules and modifiers for 96164
96164 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 · 96164
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$11.69
- Non-facility (office)
- $11.69
- Facility
- $9.35
Higher because the practice carries its own overhead.
How 96164 has changed in Nevada
96164 · Office / nonfacility
$11.64
Effective 2026-10-01
The base rate is $1.34 higher than on 2025-10-01, moving from $10.30 to $11.64 (13.0%).
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
$10.30changed to$11.64
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.23 changed to 0.24
- Practice expense RVU 0.08 changed to 0.10
- Practice expense GPCI 1.000 changed to 1.001
- Malpractice GPCI 0.844 changed to 0.833
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$10.27changed to$10.30
- Conversion factor 33.2875 changed to 32.3465
- Work RVU 0.22 changed to 0.23
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$10.10changed to$10.27
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$9.86changed to$10.10
- Conversion factor 33.8872 changed to 32.7442
- Work RVU 0.21 changed to 0.22
- Practice expense RVU 0.07 changed to 0.08
- Malpractice GPCI 1.098 changed to 0.844
January 1, 2023
RVU23A
$10.19changed to$9.86
- Conversion factor 34.6062 changed to 33.8872
- Work GPCI 1.005 changed to 1.000
- Malpractice GPCI 1.351 changed to 1.098
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$9.93changed to$10.19
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.06 changed to 0.07
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$10.18changed to$9.93
- Conversion factor 36.0896 changed to 34.8931
- Work GPCI 1.004 changed to 1.005
- Malpractice GPCI 1.130 changed to 1.351
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
No ratechanged to$10.18
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 | $11.64 | $9.30 | RVU26D |
| 2026-07-01 | $11.64 | $9.30 | RVU26C |
| 2026-04-01 | $11.64 | $9.30 | RVU26B |
| 2026-01-01 | $11.64 | $9.30 | RVU26A |
| 2025-10-01 | $10.30 | $9.33 | RVU25D |
| 2025-07-01 | $10.30 | $9.33 | RVU25C |
| 2025-04-01 | $10.30 | $9.33 | RVU25B |
| 2025-01-01 | $10.30 | $9.33 | RVU25A |
| 2024-10-01 | $10.27 | $9.27 | RVU24D |
| 2024-07-01 | $10.27 | $9.27 | RVU24C |
| 2024-04-01 | $10.27 | $9.27 | RVU24B |
| 2024-03-09 | $10.27 | $9.27 | RVU24AR |
| 2024-01-01 | $10.10 | $9.12 | RVU24A |
| 2023-10-01 | $9.86 | $8.84 | RVU23D |
| 2023-07-01 | $9.86 | $8.84 | RVU23C |
| 2023-04-01 | $9.86 | $8.84 | RVU23B |
| 2023-01-01 | $9.86 | $8.84 | RVU23A |
| 2022-10-01 | $10.19 | $9.16 | RVU22D |
| 2022-07-01 | $10.19 | $9.16 | RVU22C |
| 2022-04-01 | $10.19 | $9.16 | RVU22B |
| 2022-01-01 | $10.19 | $9.16 | RVU22A |
| 2021-10-01 | $9.93 | $8.88 | RVU21D |
| 2021-07-01 | $9.93 | $8.88 | RVU21C |
| 2021-04-01 | $9.93 | $8.88 | RVU21B |
| 2021-01-01 | $9.93 | $8.88 | RVU21A |
| 2020-10-01 | $10.18 | $9.10 | RVU20D |
| 2020-07-01 | $10.18 | $9.10 | RVU20C |
| 2020-04-01 | $10.18 | $9.10 | RVU20B |
| 2020-01-01 | $10.18 | $9.10 | 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 Nevada rate applies
Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.
- Alamo
- Amargosa Valley
- Austin
- Baker
- Battle Mountain
- Beatty
- Beaverdam
- Bennett Springs
96164 billing questions
When should 96164 be used instead of 96158?
Use 96164 when the intervention is delivered to a group of at least two patients. Use 96158 for an individual health behavior intervention.
What does 96164 include?
It covers the initial 30 minutes of face-to-face group intervention focused on behavioral factors affecting physical health or medical treatment. Document the intervention and time, rather than reporting a group assessment as treatment.
How is additional group-intervention time reported?
Use 96165 for qualifying additional time beyond the initial service. Record the time spent so the initial and additional services are supported.
Can 96164 be used for a family session?
Use the family-intervention codes when the service is family-focused. Code 96167 describes the initial service when the patient participates; 96170 is for family intervention without the patient.
What documentation supports 96164?
Document the group participants, the health-related behavioral issue addressed, the intervention performed, and the face-to-face time. The note should show how the intervention relates to physical health or treatment.
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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