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CPT code 99078: Group education, health education2026 Medicare rate & RVUs

Reports clinician-led group health education, such as prenatal, diabetes, or weight-management teaching, when patients receive shared instruction in a group setting.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · 99078

Group education, health education

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 99078 →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 99078 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 99078 covers

99078 represents health education provided to patients together as a group, including instruction about prenatal health, obesity, or diabetes. A physician or other qualified health care professional provides the teaching. The group format distinguishes this service from education materials and from separately defined group self-management training. It is reported for group health education, rather than as an individual counseling encounter.

Medicare assigns 99078 physician fee schedule status B, meaning it is not paid separately and its payment is included in payment for other services. When the service is group self-management training, 98961 or 98962 may be the appropriate specific choice, depending on group size; 99411 or 99412 describe group preventive medicine counseling. Code 99071 refers to patient education materials rather than the teaching session.

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 99078 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

99078 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

99078 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
99078 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 99078 rate is calculated

Each of 99078’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 · 99078

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 99078

99078 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 · 99078

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

—

99078 isn’t priced in this setting.

99078 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 99078

    Group education, health education0 wRVU

    Not priced

  • 98961

    Self-management education, 2-4 patients0 wRVU

    Not priced

  • 98962

    Self-management training, group of 5-80 wRVU

    Not priced

  • 99411

    Group counseling, approximately 30 minutes0.15 wRVU

    Not priced

  • 99071

    Patient education, materials supplied0 wRVU

    Not priced

How to choose

98961Self-management education2-4 patients
99078 represents group health education. 98961 is for group self-management training by a qualified health care professional, with the code selected according to group size.
98962Self-management trainingGroup of 5-8
Use 98962 for the applicable group-size category of self-management training; 99078 describes group health education rather than that specific training service.
99411Group counselingApproximately 30 minutes
99411 is for group preventive medicine counseling. Use 99078 for group health education that is not reported as that defined preventive counseling service.
99071Patient educationMaterials supplied
99071 concerns patient education materials, not the group teaching session itself. 99078 represents the education service.

Codes related to 99078

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

Codes related to 99078
CodeHow it relatesNational office range
Used instead
98961Self-management education, 2-4 patientsUse for group self-management training when that defined service is provided; group size determines the code.No office rate
98962Self-management training, group of 5-8Use for group self-management training when that defined service is provided; group size determines the code.No office rate
99411Group counseling, approximately 30 minutesGroup preventive medicine counseling when that specific counseling service is provided.No office rate
99412Group preventive counseling, approximately 60 minutesGroup preventive medicine counseling when that specific counseling service is provided.No office rate

99078 billing questions

How is 99078 different from 98961 or 98962?

99078 describes group health education. Codes 98961 and 98962 describe group self-management training by a qualified health care professional, with the applicable code selected by group size.

Does Medicare pay 99078 separately?

No. Medicare physician fee schedule status B means payment for 99078 is included in payment for other services.

Is 99078 the code for educational handouts?

No. 99078 represents the group teaching service; 99071 relates to patient education materials. The teaching session and the materials are distinct items.

When might 99411 or 99412 be considered instead?

Consider those codes when the service is group preventive medicine counseling rather than general health education. Choose based on the service provided.

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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