CPT code 96167: Family intervention, patient present, initial 30 minutes2026 Medicare rate & RVUs in Wisconsin
Report this service for a timed health behavior intervention focused on the patient’s health needs and delivered with the patient and family together.
In Wisconsin, Medicare pays $77.14 for 96167 in the office and $62.74 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 96167 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 96167 covers
A clinician works with the patient and one or more family members to address health-related behaviors, coping, adherence, or self-management. The discussion and intervention focus on the patient’s medical condition or health goals, rather than providing family psychotherapy. Physicians and other qualified health care professionals may provide this service in office or facility settings when the patient participates with family members.
Use 96167 for the initial 30 minutes of the family intervention with the patient present. Select it based on the service delivered and documented time, not simply because a family member attended another visit. The record should identify the patient-focused behavioral goal, participating family members, the intervention provided, the patient’s participation, and time spent. For qualifying additional intervention time, report 96168.
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 Wisconsin compares for 96167
Across 109 of 109 payment localities, the office rate for 96167 runs from $75.36 in Arkansas to $108.78 in Alaska. Wisconsin pays $77.14. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Wisconsin · this page$77.14
- Los Angeles, CA · California$83.89+$6.75
- Washington, DC area · District of Columbia$84.72+$7.58
- Miami, FL · Florida$79.44+$2.30
- Chicago, IL · Illinois$79.10+$1.96
- Manhattan, NY · New York$85.17+$8.03
- Alaska · Alaska$108.78+$31.64
Other areas in Wisconsin first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $75.68 | $62.52 |
| ArkansasArkansas | $75.36 | $62.45 |
| ArizonaArizona | $77.53 | $62.97 |
| Bakersfield, CACalifornia | $80.95 | $64.47 |
| Chico, CACalifornia | $80.80 | $64.33 |
| El Centro, CACalifornia | $80.81 | $64.33 |
| Fresno, CACalifornia | $80.80 | $64.33 |
| Hanford, CACalifornia | $80.80 | $64.33 |
| Madera, CACalifornia | $80.80 | $64.33 |
| Merced, CACalifornia | $80.80 | $64.33 |
| Modesto, CACalifornia | $80.80 | $64.33 |
| Napa, CACalifornia | $87.67 | $67.86 |
| Oxnard, CACalifornia | $83.09 | $65.33 |
| Redding, CACalifornia | $80.80 | $64.33 |
| Rest of CaliforniaCalifornia | $80.80 | $64.33 |
| Riverside, CACalifornia | $80.97 | $64.50 |
| Sacramento, CACalifornia | $83.18 | $65.70 |
| Salinas, CACalifornia | $82.81 | $65.39 |
| San Diego, CACalifornia | $83.44 | $65.47 |
| Marin County, CACalifornia | $91.26 | $70.07 |
| San Francisco, CACalifornia | $91.25 | $70.06 |
| San Benito County, CACalifornia | $92.77 | $71.10 |
| Santa Clara County, CACalifornia | $92.73 | $71.05 |
| San Luis Obispo, CACalifornia | $81.61 | $64.49 |
| Santa Cruz, CACalifornia | $83.27 | $65.00 |
| Santa Maria, CACalifornia | $82.76 | $65.24 |
| Santa Rosa, CACalifornia | $84.04 | $65.58 |
| Stockton, CACalifornia | $80.80 | $64.33 |
| Vallejo, CACalifornia | $87.65 | $67.84 |
| Visalia, CACalifornia | $80.80 | $64.33 |
| Yuba City, CACalifornia | $80.80 | $64.33 |
| ColoradoColorado | $79.99 | $64.00 |
| ConnecticutConnecticut | $80.85 | $64.66 |
| DelawareDelaware | $78.20 | $63.35 |
| Fort Lauderdale, FLFlorida | $78.67 | $63.45 |
| Rest of FloridaFlorida | $77.50 | $63.13 |
| Atlanta, GAGeorgia | $78.70 | $63.43 |
| Rest of GeorgiaGeorgia | $76.20 | $62.80 |
| Hawaii, Guam, HIHawaii | $80.58 | $63.49 |
| IowaIowa | $76.37 | $62.61 |
| IdahoIdaho | $76.49 | $62.66 |
| East St. Louis, ILIllinois | $77.00 | $63.17 |
| Rest of IllinoisIllinois | $76.72 | $63.00 |
| Suburban Chicago, ILIllinois | $79.33 | $63.90 |
| IndianaIndiana | $76.62 | $62.69 |
| KansasKansas | $76.20 | $62.61 |
| KentuckyKentucky | $76.05 | $62.69 |
| New Orleans, LALouisiana | $77.10 | $62.96 |
| Rest of LouisianaLouisiana | $75.99 | $62.69 |
| Metropolitan Boston, MAMassachusetts | $84.17 | $66.23 |
| Rest of MassachusettsMassachusetts | $80.03 | $64.20 |
| Baltimore area, MDMaryland | $80.55 | $64.42 |
| Rest of MarylandMaryland | $78.95 | $63.74 |
| Rest of MaineMaine | $76.54 | $62.71 |
| Southern Maine, MEMaine | $77.87 | $62.97 |
| Detroit, MIMichigan | $77.73 | $63.23 |
| Rest of MichiganMichigan | $76.57 | $62.85 |
| MinnesotaMinnesota | $78.47 | $63.00 |
| Metropolitan Kansas City, MOMissouri | $77.01 | $62.90 |
| Metropolitan St. Louis, MOMissouri | $77.26 | $62.95 |
| Rest of MissouriMissouri | $75.57 | $62.61 |
| MississippiMississippi | $75.47 | $62.53 |
| MontanaMontana | $78.16 | $63.13 |
| North CarolinaNorth Carolina | $76.78 | $62.76 |
| North DakotaNorth Dakota | $77.96 | $62.93 |
| NebraskaNebraska | $76.51 | $62.64 |
| New HampshireNew Hampshire | $78.88 | $63.24 |
| Northern New JerseyNew Jersey | $84.90 | $67.46 |
| Rest of New JerseyNew Jersey | $82.28 | $65.86 |
| New MexicoNew Mexico | $76.67 | $62.89 |
| NevadaNevada | $78.12 | $63.08 |
| NYC suburbs and Long Island, NYNew York | $85.76 | $67.89 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $82.67 | $66.21 |
| Queens, NYNew York | $85.49 | $67.73 |
| Rest of New YorkNew York | $77.12 | $62.84 |
| OhioOhio | $76.53 | $62.81 |
| OklahomaOklahoma | $76.08 | $62.66 |
| Portland, OROregon | $81.09 | $64.40 |
| Rest of OregonOregon | $77.98 | $63.01 |
| Metropolitan Philadelphia, PAPennsylvania | $80.05 | $64.41 |
| Rest of PennsylvaniaPennsylvania | $76.61 | $62.81 |
| Puerto RicoPuerto Rico | $78.36 | $63.16 |
| Rhode IslandRhode Island | $79.86 | $64.34 |
| South CarolinaSouth Carolina | $76.69 | $62.80 |
| South DakotaSouth Dakota | $77.94 | $62.91 |
| TennesseeTennessee | $76.30 | $62.64 |
| Austin, TXTexas | $79.32 | $63.42 |
| Beaumont, TXTexas | $76.45 | $62.77 |
| Brazoria, TXTexas | $78.39 | $63.49 |
| Dallas, TXTexas | $78.57 | $63.60 |
| Fort Worth, TXTexas | $78.39 | $63.57 |
| Galveston, TXTexas | $78.44 | $63.52 |
| Houston, TXTexas | $78.63 | $63.70 |
| Rest of TexasTexas | $77.17 | $62.91 |
| UtahUtah | $77.00 | $62.87 |
| VirginiaVirginia | $77.74 | $62.97 |
| Virgin Islands, VIUnited States Virgin Islands | $78.36 | $63.16 |
| VermontVermont | $77.81 | $62.93 |
| Rest of WashingtonWashington | $79.84 | $64.01 |
| King County, WAWashington | $85.30 | $66.86 |
| West VirginiaWest Virginia | $75.85 | $62.79 |
| WyomingWyoming | $78.07 | $63.04 |
96167 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.
$75.36
$108.78
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 | $108.78 | 1 |
| AL | $75.68 | 1 |
| AR | $75.36 | 1 |
| AZ | $77.53 | 1 |
| CA | $80.80–$92.77 | 29 |
| CO | $79.99 | 1 |
| CT | $80.85 | 1 |
| DC | $84.72 | 1 |
| DE | $78.20 | 1 |
| FL | $77.50–$79.44 | 3 |
| GA | $76.20–$78.70 | 2 |
| GU | $80.58 | 1 |
| HI | $80.58 | 1 |
| IA | $76.37 | 1 |
| ID | $76.49 | 1 |
| IL | $76.72–$79.33 | 4 |
| IN | $76.62 | 1 |
| KS | $76.20 | 1 |
| KY | $76.05 | 1 |
| LA | $75.99–$77.10 | 2 |
| MA | $80.03–$84.17 | 2 |
| MD | $78.95–$84.72 | 3 |
| ME | $76.54–$77.87 | 2 |
| MI | $76.57–$77.73 | 2 |
| MN | $78.47 | 1 |
| MO | $75.57–$77.26 | 3 |
| MS | $75.47 | 1 |
| MT | $78.16 | 1 |
| NC | $76.78 | 1 |
| ND | $77.96 | 1 |
| NE | $76.51 | 1 |
| NH | $78.88 | 1 |
| NJ | $82.28–$84.90 | 2 |
| NM | $76.67 | 1 |
| NV | $78.12 | 1 |
| NY | $77.12–$85.76 | 5 |
| OH | $76.53 | 1 |
| OK | $76.08 | 1 |
| OR | $77.98–$81.09 | 2 |
| PA | $76.61–$80.05 | 2 |
| PR | $78.36 | 1 |
| RI | $79.86 | 1 |
| SC | $76.69 | 1 |
| SD | $77.94 | 1 |
| TN | $76.30 | 1 |
| TX | $76.45–$79.32 | 8 |
| UT | $77.00 | 1 |
| VA | $77.74–$84.72 | 2 |
| VI | $78.36 | 1 |
| VT | $77.81 | 1 |
| WA | $79.84–$85.30 | 2 |
| WI | $77.14 | 1 |
| WV | $75.85 | 1 |
| WY | $78.07 | 1 |
How the 96167 rate is calculated
Each of 96167’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 · 96167
RVUs × geographic indexes × conversion factor
Work1.77
1.77 RVUs× 1.000 GPCI
Practice expense0.56
0.56 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
2.3400
Conversion factor
$33.4009
Medicare rate
$78.16
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Wisconsin inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,771
- Code
- 96167
- Physician work
- 1.77
- Practice expense
- 0.56
- Malpractice
- 0.01
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.77 | × 1.000 | 1.7700 |
| Practice expense | 0.56 | × 0.958 | 0.5365 |
| Malpractice | 0.01 | × 0.308 | 0.0031 |
| Total RVUs | 2.3096 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Wisconsin$77.14
Office: (1.77 × 1 + 0.56 × 0.958 + 0.01 × 0.308) × $33.4009 = $77.14
Facility: (1.77 × 1 + 0.11 × 0.958 + 0.01 × 0.308) × $33.4009 = $62.74
Payment rules and modifiers for 96167
96167 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 · 96167
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$78.16
- Non-facility (office)
- $78.16
- Facility
- $63.13
Higher because the practice carries its own overhead.
How 96167 has changed in Wisconsin
96167 · Office / nonfacility
$77.14
Effective 2026-10-01
The base rate is $6.55 higher than on 2025-10-01, moving from $70.59 to $77.14 (9.3%).
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
$70.59changed to$77.14
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.70 changed to 1.77
- Practice expense RVU 0.49 changed to 0.56
- Malpractice RVU 0.04 changed to 0.01
- Practice expense GPCI 0.957 changed to 0.958
- Malpractice GPCI 0.331 changed to 0.308
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$69.02changed to$70.59
- Conversion factor 33.2875 changed to 32.3465
- Work RVU 1.62 changed to 1.70
- Practice expense RVU 0.46 changed to 0.49
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$67.89changed to$69.02
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$67.44changed to$67.89
- Conversion factor 33.8872 changed to 32.7442
- Work RVU 1.55 changed to 1.62
- Practice expense RVU 0.45 changed to 0.46
- Practice expense GPCI 0.950 changed to 0.957
- Malpractice GPCI 0.314 changed to 0.331
January 1, 2023
RVU23A
$68.70changed to$67.44
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.44 changed to 0.45
- Malpractice RVU 0.07 changed to 0.04
- Practice expense GPCI 0.942 changed to 0.950
- Malpractice GPCI 0.296 changed to 0.314
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$69.06changed to$68.70
- Conversion factor 34.8931 changed to 34.6062
- Malpractice RVU 0.05 changed to 0.07
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$71.02changed to$69.06
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.42 changed to 0.44
- Malpractice RVU 0.06 changed to 0.05
- Practice expense GPCI 0.949 changed to 0.942
- Malpractice GPCI 0.322 changed to 0.296
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
No ratechanged to$71.02
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 | $77.14 | $62.74 | RVU26D |
| 2026-07-01 | $77.14 | $62.74 | RVU26C |
| 2026-04-01 | $77.14 | $62.74 | RVU26B |
| 2026-01-01 | $77.14 | $62.74 | RVU26A |
| 2025-10-01 | $70.59 | $61.92 | RVU25D |
| 2025-07-01 | $70.59 | $61.92 | RVU25C |
| 2025-04-01 | $70.59 | $61.92 | RVU25B |
| 2025-01-01 | $70.59 | $61.92 | RVU25A |
| 2024-10-01 | $69.02 | $60.74 | RVU24D |
| 2024-07-01 | $69.02 | $60.74 | RVU24C |
| 2024-04-01 | $69.02 | $60.74 | RVU24B |
| 2024-03-09 | $69.02 | $60.74 | RVU24AR |
| 2024-01-01 | $67.89 | $59.75 | RVU24A |
| 2023-10-01 | $67.44 | $59.39 | RVU23D |
| 2023-07-01 | $67.44 | $59.39 | RVU23C |
| 2023-04-01 | $67.44 | $59.39 | RVU23B |
| 2023-01-01 | $67.44 | $59.39 | RVU23A |
| 2022-10-01 | $68.70 | $61.20 | RVU22D |
| 2022-07-01 | $68.70 | $61.20 | RVU22C |
| 2022-04-01 | $68.70 | $61.20 | RVU22B |
| 2022-01-01 | $68.70 | $61.20 | RVU22A |
| 2021-10-01 | $69.06 | $61.17 | RVU21D |
| 2021-07-01 | $69.06 | $61.17 | RVU21C |
| 2021-04-01 | $69.06 | $61.17 | RVU21B |
| 2021-01-01 | $69.06 | $61.17 | RVU21A |
| 2020-10-01 | $71.02 | $64.17 | RVU20D |
| 2020-07-01 | $71.02 | $64.17 | RVU20C |
| 2020-04-01 | $71.02 | $64.17 | RVU20B |
| 2020-01-01 | $71.02 | $64.17 | 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 Wisconsin rate applies
Wisconsin is a Medicare payment area, not a city. Our Census mapping connects it to 807 cities and communities in Wisconsin. Some span more than one payment area; confirm with the service ZIP.
- Abbotsford
- Abrams
- Adams
- Adell
- Albany
- Algoma
- Allens Grove
- Allenton
96167 billing questions
When should I use 96167 rather than 96170?
Use 96167 when the patient participates in the family intervention. Use 96170 when the family intervention is conducted without the patient present.
What code reports additional intervention time?
Use 96168 for qualifying additional time beyond the initial 30-minute service. Document the intervention and the time that supports the additional service.
Can I report 96167 for family psychotherapy?
No. The intervention must address the patient’s health behavior or health-related needs; family psychotherapy is a different service.
How does 96167 differ from 96158?
96167 describes a patient-focused intervention involving family with the patient present. 96158 is for an individual health behavior intervention.
What should the note include?
Document the health-related goal, the patient and family members present, the intervention performed, the patient’s involvement, and the time spent.
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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