CPT code 97154: Group behavior treatment, technician, per 15 minutes2026 Medicare rate & RVUs in Guam
Reports technician-delivered, protocol-based adaptive behavior treatment face-to-face with multiple patients in a group, in 15-minute units.
CMS doesn’t publish an office rate for 97154 in Guam.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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.
97154 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | Unavailable | Unavailable |
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
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
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97154 isn’t priced in this setting.
97154 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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