Billing code 96203: Family trainingMedicare rate & RVUs
Reports each additional 30 minutes of group behavior management training for caregivers from multiple families, following the initial service for patients with a health diagnosis.
Medicare pays $5.34 for 96203 nationally in the office and $5.01 in a hospital or facility. Local office rates run $5.04–$7.26.
Medicare rate · 96203
Family training
Swap in your local Medicare rate.
- Work RVUs
- 0.12
- Total RVUs
- 0.16
- Global days
- ZZZ
National rate · 2026
$5.34
Office setting, before claim adjustments.
See every locality for 96203 → · 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.
On this page 10 sections
What 96203 covers
This add-on represents additional face-to-face time providing behavior management or modification training to caregivers from multiple families. The patients have a mental or physical health diagnosis and are not present during the training. A physician or other qualified health care professional may provide the service in a behavioral health, medical, or other appropriate care setting. The group format involves caregivers representing more than one patient or family, rather than a single family receiving individualized instruction.
Report 96203 only with the initial multiple-family group training service, 96202. Each unit represents an additional 30 minutes after the time represented by the primary code. Documentation should identify the caregiver group, the training provided, the patients’ relevant diagnoses, the patients’ absence, and the additional time furnished. CMS treats 96203 as an add-on code: it must be billed with a primary procedure, and its payment falls within that procedure’s global period.
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 96203 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$5.04 to $7.26
109 of 109 payment localities
96203 rates by state
Office rate range in each state. Select a state to see its payment localities.
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Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$5.04
$7.26
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $7.26 | 1 |
| AL | $5.07 | 1 |
| AR | $5.04 | 1 |
| AZ | $5.26 | 1 |
| CA | $5.35–$6.07 | 29 |
| CO | $5.38 | 1 |
| CT | $5.57 | 1 |
| DC | $5.78 | 1 |
| DE | $5.32 | 1 |
| FL | $5.47–$5.90 | 3 |
| GA | $5.30–$5.44 | 2 |
| GU | $5.34 | 1 |
| HI | $5.34 | 1 |
| IA | $5.06 | 1 |
| ID | $5.09 | 1 |
| IL | $5.45–$5.81 | 4 |
| IN | $5.10 | 1 |
| KS | $5.08 | 1 |
| KY | $5.20 | 1 |
| LA | $5.21–$5.33 | 2 |
| MA | $5.39–$5.67 | 2 |
| MD | $5.37–$5.78 | 3 |
| ME | $5.14–$5.21 | 2 |
| MI | $5.30–$5.54 | 2 |
| MN | $5.14 | 1 |
| MO | $5.20–$5.30 | 3 |
| MS | $5.12 | 1 |
| MT | $5.34 | 1 |
| NC | $5.16 | 1 |
| ND | $5.15 | 1 |
| NE | $5.06 | 1 |
| NH | $5.34 | 1 |
| NJ | $5.63–$5.78 | 2 |
| NM | $5.33 | 1 |
| NV | $5.29 | 1 |
| NY | $5.19–$6.08 | 5 |
| OH | $5.26 | 1 |
| OK | $5.16 | 1 |
| OR | $5.24–$5.43 | 2 |
| PA | $5.24–$5.52 | 2 |
| PR | $5.35 | 1 |
| RI | $5.42 | 1 |
| SC | $5.22 | 1 |
| SD | $5.12 | 1 |
| TN | $5.10 | 1 |
| TX | $5.23–$5.49 | 8 |
| UT | $5.25 | 1 |
| VA | $5.23–$5.78 | 2 |
| VI | $5.35 | 1 |
| VT | $5.17 | 1 |
| WA | $5.37–$5.71 | 2 |
| WI | $5.07 | 1 |
| WV | $5.36 | 1 |
| WY | $5.26 | 1 |
How the 96203 rate is calculated
Each of 96203’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 · 96203
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.12Practice expense 0.03Malpractice 0.01
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 96203
The CMS indicators that decide how 96203 is paid alongside other services.
CMS payment indicators · 96203
Family training
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
96203 compared with similar codes
Compare codes
96203 vs 96202 vs 96167 vs 96170: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 96202Caregiver training
- 96202 represents the initial multiple-family group training service; 96203 represents each additional 30 minutes and is reported with 96202.
- 96167Family intervention
- 96167 describes family health behavior intervention without the patient present. Use 96203 only for additional time in the multiple-family group behavior management training service.
- 96170Hlth bhv ivntj fam wo pt 1st
- 96170 is family health behavior intervention with the patient present. 96203 is for additional time in multiple-family caregiver training with patients absent.
96203 billing questions
Which code must accompany 96203?
Report 96203 with 96202, the code for the initial multiple-family group behavior management or modification training service.
How is the time represented?
Each unit of 96203 represents an additional 30 minutes of training beyond the initial service. Document the additional time furnished.
Must the patients attend the group?
No. This service is for caregivers from multiple families, with the patients absent.
Can 96203 be reported for one family's caregivers?
No. The service is a multiple-family group; individualized family intervention is a different service.
How does CMS treat payment for this add-on?
96203 is billed only with a primary procedure, and CMS places its payment within that primary procedure’s global period.
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
Show the CMS file lines behind this rate
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