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CPT code 97154: Group behavior treatment, technician, per 15 minutes2026 Medicare rate & RVUs

Reports technician-delivered, protocol-based adaptive behavior treatment face-to-face with multiple patients in a group, in 15-minute units.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · 97154

Group behavior treatment, technician, per 15 minutes

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for 97154 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 97154 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 97154 covers

This code describes protocol-based adaptive behavior treatment delivered face-to-face by a technician to two or more patients in a group. The technician provides the service under the direction of a physician or other qualified health care professional. The code distinguishes group treatment from technician-delivered treatment for one patient and from group treatment delivered by a physician or qualified health care professional with protocol modification.

For Medicare physician fee schedule purposes, status C means CMS publishes no national payment; the Medicare Administrative Contractor sets payment for each claim. Each unit represents 15 minutes of the qualifying group service. Documentation should identify the group service, the technician’s role, and the time spent.

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 97154 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

97154 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

97154 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

View every state and territory as a table
97154 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 97154 rate is calculated

Each of 97154’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 · 97154

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

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

Payment rules and modifiers for 97154

97154 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 · 97154

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

97154 isn’t priced in this setting.

97154 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 97154

    Group behavior treatment, technician, per 15 minutes0 wRVU

    Not priced

  • 97153

    Adaptive behavior treatment, one patient, technician0 wRVU

    Not priced

  • 97158

    Group adaptive treatment, QHP protocol modification0 wRVU

    Not priced

  • 97150

    Group therapy, two or more patients, per session0.29 wRVU

    $18.04

How to choose

97153Adaptive behavior treatmentOne patient, technician
Both describe technician-delivered adaptive behavior treatment by protocol. Choose 97154 for face-to-face treatment with two or more patients and 97153 for treatment with one patient.
97158Group adaptive treatmentQHP protocol modification
Both describe group adaptive behavior treatment. 97154 is technician-delivered by protocol; 97158 is delivered by a physician or other qualified health care professional with protocol modification.
97150Group therapyTwo or more patients, per session
97150 describes group therapeutic procedures generally. 97154 is specific to technician-delivered, protocol-based group adaptive behavior treatment.

Codes related to 97154

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

Codes related to 97154
CodeHow it relatesNational office range
Used instead
97153Adaptive behavior treatment, one patient, technicianTechnician-delivered adaptive behavior treatment for one patient rather than a group.No office rate
Same family
97158Group adaptive treatment, QHP protocol modificationGroup adaptive behavior treatment with protocol modification, delivered by a physician or qualified health care professional.No office rate
97155Behavior treatment, protocol modificationAdaptive behavior treatment with protocol modification, delivered by a physician or qualified health care professional.No office rate

97154 billing questions

When should 97154 be used instead of 97153?

Use 97154 for technician-delivered, protocol-based treatment face-to-face with two or more patients. Use 97153 for the corresponding treatment with one patient.

How many units are reported?

Each unit represents 15 minutes of qualifying group treatment. Documentation should support the time reported.

How does 97154 differ from 97158?

Both describe group adaptive behavior treatment. 97154 is technician-delivered by protocol; 97158 is delivered by a physician or other qualified health care professional with protocol modification.

What should documentation identify?

Document the group format, the technician’s role, the treatment provided, and the time spent.

How does Medicare set payment for 97154?

It has physician fee schedule status C. CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim.

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

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