CPT code 99078: Group education, health education2026 Medicare rate & RVUs in Missouri
Reports clinician-led group health education, such as prenatal, diabetes, or weight-management teaching, when patients receive shared instruction in a group setting.
CMS doesn’t publish an office rate for 99078 in Missouri.
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 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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | Unavailable |
| Metropolitan St. Louis, MO | Unavailable | Unavailable |
| Rest of Missouri | Unavailable | Unavailable |
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
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
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99078 isn’t priced in this setting.
99078 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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