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

CMS doesn’t publish an office rate for 97154 in California.

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

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 in California

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

29 of 29 payment localities

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.

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.

97154 compared with similar codes

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.

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