CPT code 96170: Family intervention, patient absent2026 Medicare rate & RVUs

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

What 96170 covers

This service covers face-to-face work with a patient’s family members, without the patient present, to address behavioral, emotional, cognitive, or social factors affecting the patient’s physical health or treatment. A qualified health care professional may use the session to help family members support care plans, health-related behavior changes, or management of a medical condition. It is an intervention, not a health behavior assessment or a session delivered to the patient individually.

Code 96170 represents the initial 30 minutes; 96171 is used for each additional 15 minutes of this family intervention. Select the family code that matches whether the patient is present: 96170 is for the patient-absent format, while 96167 is the initial family service with the patient present. Medicare physician fee schedule status N means Medicare does not cover this service.

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.

Where 96170 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

96170 rates by state

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

How the 96170 rate is calculated

Each of 96170’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 96170

96170 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.

96170 compared with similar codes

How to choose

96167Family interventionPatient present, initial 30 minutes

Both are initial family health behavior interventions. Use 96170 when the patient is absent and 96167 when the patient is present.

96168Family interventionEach additional 15 minutes

96168 reports additional time for a family intervention with the patient present; 96170 is the initial service when the patient is absent.

96171Family interventionWithout patient, each 15 minutes

96171 reports additional 15-minute intervals after the initial patient-absent family intervention; 96170 represents its initial 30 minutes.

96158Health behaviorIndividual, initial 30 minutes

96158 is an initial individual intervention with the patient, rather than a family intervention conducted without the patient.

Codes related to 96170

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

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