CPT code 96165: Group intervention, each additional 30 minutes2026 Medicare rate & RVUs in Connecticut

In Connecticut, Medicare pays $5.19 for 96165 in the office and $4.11 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 96165 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 96165 covers

A physician or other qualified health care professional uses this add-on service to address behavioral, emotional, social, or cognitive factors affecting patients’ physical health and treatment. In a group session, participants receive intervention directed toward health-related goals such as improving self-management or supporting adherence to a treatment plan. The service may be provided in an office or facility; the group format, rather than an individual or family session, distinguishes it from related intervention services.

Report 96165 only with the primary group intervention code 96164, for additional intervention time beyond the initial segment. Documentation should identify the health-related behavioral goals, the intervention provided, the group format, and the time supporting the additional segment. CMS classifies 96165 as an add-on code: it is billed only with a primary procedure and paid within that procedure’s global period. It is not a stand-alone report for a group session.

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 Connecticut compares for 96165

Across 109 of 109 payment localities, the office rate for 96165 runs from $4.82 in Arkansas to $6.93 in Alaska. Connecticut pays $5.19. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

96165 rates by state

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

See 96165 in every payment locality

How the 96165 rate is calculated

Each of 96165’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 96165

The CMS indicators that decide how 96165 is paid alongside other services.

Codes related to 96165

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

How 96165 has changed in Connecticut

Price 96165 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

• Ansonia
• Ball Pond
• Baltic
• Bantam
• Bethel
• Bethlehem Village
• Bigelow Corners
• Blue Hills

Browse all communities in Connecticut

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