CPT code 97156: Family guidance, adaptive behavior2026 Medicare rate & RVUs in Connecticut

CMS doesn’t publish a rate for 97156 in Connecticut.

Check a contract rate as a % of Medicare · 97156 nationwide

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

What 97156 covers

97156 covers face-to-face adaptive behavior treatment guidance provided by a physician or other qualified health care professional to a patient’s guardian or caregiver. The guidance may help the family apply treatment strategies in the patient’s daily routines and support the behavior plan. The patient may be present or absent; this service is distinct from direct adaptive behavior treatment delivered to the patient and from guidance provided to multiple families together.

For Medicare physician fee schedule purposes, 97156 has status C, or carrier priced: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. Report the service in 15-minute units. The reported time is for face-to-face guidance with the guardian or caregiver, rather than time spent providing direct adaptive behavior treatment to the patient.

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 Connecticut compares for 97156

Every other payment area

97156 rates by state

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

See 97156 in every payment locality

How the 97156 rate is calculated

Each of 97156’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 97156

97156 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.

Codes related to 97156

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

How 97156 has changed in Connecticut

Price 97156 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

• Ansonia
• Ball Pond
• Baltic
• Bantam
• Bethel
• Bethlehem Village
• Bigelow Corners
• Blue Hills

Browse all communities in Connecticut

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