CPT code 97157: Family behavior guidance, multiple-family group2026 Medicare rate & RVUs in Florida
Clinician-led, face-to-face guidance for caregivers from multiple families, reported in 15-minute units while patients are absent.
CMS doesn’t publish an office rate for 97157 in Florida.
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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On this page 9 sections
What 97157 covers
This service is face-to-face adaptive behavior guidance for caregivers from more than one family in a group. A physician or other qualified health care professional leads the session, helping caregivers address adaptive behavior goals. The patient is not present. The service is caregiver guidance, not direct adaptive behavior treatment delivered to patients by a technician.
CPT Category I code 97157 has physician fee schedule status C, or carrier priced. CMS publishes no national payment; the Medicare Administrative Contractor sets payment for each claim. Each unit represents 15 minutes of face-to-face guidance. Use 97156 for guidance involving one family; use 97158 for group adaptive behavior treatment delivered to patients by a physician or other qualified health care professional.
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 97157 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale, FL | Unavailable | Unavailable |
| Miami, FL | Unavailable | Unavailable |
| Rest of Florida | Unavailable | Unavailable |
How the 97157 rate is calculated
Each of 97157’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 · 97157
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 97157
97157 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 · 97157
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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97157 isn’t priced in this setting.
97157 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 97156Family guidanceAdaptive behavior
- 97156 is caregiver guidance for one family. 97157 is for caregivers from multiple families in the same session.
- 97158Group adaptive treatmentQHP protocol modification
- 97158 describes clinician-led group treatment with patients present; 97157 is guidance for caregivers while patients are absent.
- 97154Group behavior treatmentTechnician, per 15 minutes
- 97154 is group adaptive behavior treatment delivered by a technician to patients. 97157 is clinician-led guidance for caregivers from multiple families.
- 97155Behavior treatmentProtocol modification
- 97155 involves adaptive behavior treatment with protocol modification for a patient; 97157 is group guidance directed to caregivers.
97157 billing questions
When should I use 97157 rather than 97156?
Use 97157 for face-to-face guidance involving caregivers from multiple families. Use 97156 when guidance is provided to caregivers from one family.
Are patients present during 97157?
No. This code describes caregiver guidance delivered while the patients are absent.
What does one unit of 97157 represent?
One unit represents 15 minutes of face-to-face guidance by a physician or other qualified health care professional.
How is 97157 different from 97158?
97157 is guidance for caregivers from multiple families, with patients absent. 97158 is group adaptive behavior treatment delivered by a physician or other qualified health care professional to patients.
Does status C establish a national Medicare payment?
No. Status C means CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim.
What should the session record show?
Document the caregiver guidance provided, participation by caregivers from multiple families, the adaptive behavior goals addressed, and the session time.
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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