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CMS RVU26D · Effective 2026-10-01

96165 in Austin

Office / nonfacility

$5.09

Base rate per service

Facility setting

$4.03

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Health behavior intervention

About 96165: Additional group health behavior intervention

Report 96165 for each additional 30-minute segment of a health behavior intervention delivered face-to-face to a group of patients.

A physician or other qualified health care professional uses this add-on service to address behavioral, emotional, social, or cognitive factors affecting patients’ physical health and treatment. In a group session, participants receive intervention directed toward health-related goals such as improving self-management or supporting adherence to a treatment plan. The service may be provided in an office or facility; the group format, rather than an individual or family session, distinguishes it from related intervention services.

Report 96165 only with the primary group intervention code 96164, for additional intervention time beyond the initial segment. Documentation should identify the health-related behavioral goals, the intervention provided, the group format, and the time supporting the additional segment. CMS classifies 96165 as an add-on code: it is billed only with a primary procedure and paid within that procedure’s global period. It is not a stand-alone report for a group session.

CMS billing rules for 96165

Global period
Add-on code: billed only together with a primary procedure and paid within that procedure's global period.

Where the value comes from

  • Work RVU0.11 · 73%
  • Practice expense (office) RVU0.04 · 27%
  • Malpractice RVU0.00 · 0%

36.6K

Medicare services in 2024 · #903 by national volume

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.

96165 compared with similar codes

Office rates for Austin, from the same CMS release.

96164

Group intervention

First 30 minutes

$11.86

96164 covers the initial group intervention segment; 96165 is reserved for additional time and must accompany 96164.

96159

Health behavior intervention

Individual, additional time

$25.79

96159 is for additional individual intervention time with one patient; 96165 is for additional time in a group session.

96168

Family intervention

Each additional 15 minutes

$28.80

96168 covers additional time in a family intervention session, while 96165 applies to a group intervention session.

The same code, a different location

How does Austin compare?

In Beaumont, the office rate for 96165 is $4.89—$0.20 lower than the $5.09 rate in Austin. Both use the same code, release and participation basis.

96165 across payment areas

Same release and payment basis · bars start at $0

  1. Austin · This locality

    $5.09

  2. Beaumont

    $4.89

    $0.20 lower than Austin

  3. Brazoria

    $5.03

    $0.06 lower than Austin

  4. Dallas

    $5.04

    $0.05 lower than Austin

  5. Fort Worth

    $5.02

    $0.07 lower than Austin

  6. Galveston

    $5.03

    $0.06 lower than Austin

  7. Houston

    $5.03

    $0.06 lower than Austin

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 96165 ranges from $4.82 in Arkansas to $6.93 in Alaska*. This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Rest Of Texas

    Texas · 96165

    Office

    $4.94

    Facility

    $3.99

    $0.15 lower than Austin for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 96165

    Office

    $5.41

    Facility

    $4.22

    $0.32 higher than Austin for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 96165

    Office

    $5.45

    Facility

    $4.27

    $0.36 higher than Austin for the office setting.

  • Miami

    Florida · 96165

    Office

    $5.06

    Facility

    $4.02

    $0.03 lower than Austin for the office setting.

  • Chicago

    Illinois · 96165

    Office

    $5.04

    Facility

    $4.04

    $0.05 lower than Austin for the office setting.

  • Manhattan

    New York · 96165

    Office

    $5.46

    Facility

    $4.30

    $0.37 higher than Austin for the office setting.

  • Alaska*

    Alaska · 96165

    Office

    $6.93

    Facility

    $5.87

    $1.84 higher than Austin for the office setting.

  • Alabama

    Alabama · 96165

    Office

    $4.84

    Facility

    $3.97

    $0.25 lower than Austin for the office setting.

  • Arkansas

    Arkansas · 96165

    Office

    $4.82

    Facility

    $3.96

    $0.27 lower than Austin for the office setting.

  • Arizona

    Arizona · 96165

    Office

    $4.97

    Facility

    $4.00

    $0.12 lower than Austin for the office setting.

  • Bakersfield

    California · 96165

    Office

    $5.21

    Facility

    $4.11

    $0.12 higher than Austin for the office setting.

  • Chico

    California · 96165

    Office

    $5.20

    Facility

    $4.10

    $0.11 higher than Austin for the office setting.

  • El Centro

    California · 96165

    Office

    $5.20

    Facility

    $4.10

    $0.11 higher than Austin for the office setting.

  • Fresno

    California · 96165

    Office

    $5.20

    Facility

    $4.10

    $0.11 higher than Austin for the office setting.

  • Hanford-Corcoran

    California · 96165

    Office

    $5.20

    Facility

    $4.10

    $0.11 higher than Austin for the office setting.

  • Madera

    California · 96165

    Office

    $5.20

    Facility

    $4.10

    $0.11 higher than Austin for the office setting.

  • Merced

    California · 96165

    Office

    $5.20

    Facility

    $4.10

    $0.11 higher than Austin for the office setting.

  • Modesto

    California · 96165

    Office

    $5.20

    Facility

    $4.10

    $0.11 higher than Austin for the office setting.

  • Napa

    California · 96165

    Office

    $5.67

    Facility

    $4.35

    $0.58 higher than Austin for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 96165

    Office

    $5.36

    Facility

    $4.17

    $0.27 higher than Austin for the office setting.

  • Redding

    California · 96165

    Office

    $5.20

    Facility

    $4.10

    $0.11 higher than Austin for the office setting.

  • Rest Of California

    California · 96165

    Office

    $5.20

    Facility

    $4.10

    $0.11 higher than Austin for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 96165

    Office

    $5.20

    Facility

    $4.11

    $0.11 higher than Austin for the office setting.

  • Sacramento-Roseville-Folsom

    California · 96165

    Office

    $5.36

    Facility

    $4.19

    $0.27 higher than Austin for the office setting.

  • Salinas

    California · 96165

    Office

    $5.34

    Facility

    $4.18

    $0.25 higher than Austin for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 96165

    Office

    $5.38

    Facility

    $4.18

    $0.29 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 96165

    Office

    $5.91

    Facility

    $4.49

    $0.82 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 96165

    Office

    $5.91

    Facility

    $4.49

    $0.82 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 96165

    Office

    $6.00

    Facility

    $4.56

    $0.91 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 96165

    Office

    $6.00

    Facility

    $4.56

    $0.91 higher than Austin for the office setting.

  • San Luis Obispo-Paso Robles

    California · 96165

    Office

    $5.26

    Facility

    $4.12

    $0.17 higher than Austin for the office setting.

  • Santa Cruz-Watsonville

    California · 96165

    Office

    $5.37

    Facility

    $4.16

    $0.28 higher than Austin for the office setting.

  • Santa Maria-Santa Barbara

    California · 96165

    Office

    $5.33

    Facility

    $4.17

    $0.24 higher than Austin for the office setting.

  • Santa Rosa-Petaluma

    California · 96165

    Office

    $5.42

    Facility

    $4.19

    $0.33 higher than Austin for the office setting.

  • Stockton

    California · 96165

    Office

    $5.20

    Facility

    $4.10

    $0.11 higher than Austin for the office setting.

  • Vallejo

    California · 96165

    Office

    $5.67

    Facility

    $4.35

    $0.58 higher than Austin for the office setting.

  • Visalia

    California · 96165

    Office

    $5.20

    Facility

    $4.10

    $0.11 higher than Austin for the office setting.

  • Yuba City

    California · 96165

    Office

    $5.20

    Facility

    $4.10

    $0.11 higher than Austin for the office setting.

  • Colorado

    Colorado · 96165

    Office

    $5.14

    Facility

    $4.07

    $0.05 higher than Austin for the office setting.

  • Connecticut

    Connecticut · 96165

    Office

    $5.19

    Facility

    $4.11

    $0.10 higher than Austin for the office setting.

  • Delaware

    Delaware · 96165

    Office

    $5.01

    Facility

    $4.02

    $0.08 lower than Austin for the office setting.

  • Fort Lauderdale

    Florida · 96165

    Office

    $5.03

    Facility

    $4.01

    $0.06 lower than Austin for the office setting.

  • Rest Of Florida

    Florida · 96165

    Office

    $4.95

    Facility

    $3.99

    $0.14 lower than Austin for the office setting.

  • Atlanta

    Georgia · 96165

    Office

    $5.04

    Facility

    $4.02

    $0.05 lower than Austin for the office setting.

  • Rest Of Georgia

    Georgia · 96165

    Office

    $4.87

    Facility

    $3.97

    $0.22 lower than Austin for the office setting.

  • Hawaii, Guam

    Hawaii · 96165

    Office

    $5.19

    Facility

    $4.05

    $0.10 higher than Austin for the office setting.

  • Iowa

    Iowa · 96165

    Office

    $4.90

    Facility

    $3.98

    $0.19 lower than Austin for the office setting.

  • Idaho

    Idaho · 96165

    Office

    $4.90

    Facility

    $3.98

    $0.19 lower than Austin for the office setting.

  • East St. Louis

    Illinois · 96165

    Office

    $4.90

    Facility

    $3.98

    $0.19 lower than Austin for the office setting.

  • Rest Of Illinois

    Illinois · 96165

    Office

    $4.89

    Facility

    $3.98

    $0.20 lower than Austin for the office setting.

  • Suburban Chicago

    Illinois · 96165

    Office

    $5.07

    Facility

    $4.04

    $0.02 lower than Austin for the office setting.

  • Indiana

    Indiana · 96165

    Office

    $4.91

    Facility

    $3.98

    $0.18 lower than Austin for the office setting.

  • Kansas

    Kansas · 96165

    Office

    $4.88

    Facility

    $3.98

    $0.21 lower than Austin for the office setting.

  • Kentucky

    Kentucky · 96165

    Office

    $4.86

    Facility

    $3.97

    $0.23 lower than Austin for the office setting.

  • New Orleans

    Louisiana · 96165

    Office

    $4.93

    Facility

    $3.99

    $0.16 lower than Austin for the office setting.

  • Rest Of Louisiana

    Louisiana · 96165

    Office

    $4.86

    Facility

    $3.97

    $0.23 lower than Austin for the office setting.

  • Metropolitan Boston

    Massachusetts · 96165

    Office

    $5.42

    Facility

    $4.22

    $0.33 higher than Austin for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 96165

    Office

    $5.14

    Facility

    $4.08

    $0.05 higher than Austin for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 96165

    Office

    $5.17

    Facility

    $4.09

    $0.08 higher than Austin for the office setting.

  • Rest Of Maryland

    Maryland · 96165

    Office

    $5.06

    Facility

    $4.05

    $0.03 lower than Austin for the office setting.

  • Rest Of Maine

    Maine · 96165

    Office

    $4.90

    Facility

    $3.98

    $0.19 lower than Austin for the office setting.

  • Southern Maine

    Maine · 96165

    Office

    $5.00

    Facility

    $4.01

    $0.09 lower than Austin for the office setting.

  • Detroit

    Michigan · 96165

    Office

    $4.96

    Facility

    $4.00

    $0.13 lower than Austin for the office setting.

  • Rest Of Michigan

    Michigan · 96165

    Office

    $4.89

    Facility

    $3.98

    $0.20 lower than Austin for the office setting.

  • Minnesota

    Minnesota · 96165

    Office

    $5.05

    Facility

    $4.02

    $0.04 lower than Austin for the office setting.

  • Metropolitan Kansas City

    Missouri · 96165

    Office

    $4.93

    Facility

    $3.99

    $0.16 lower than Austin for the office setting.

  • Metropolitan St. Louis

    Missouri · 96165

    Office

    $4.95

    Facility

    $3.99

    $0.14 lower than Austin for the office setting.

  • Rest Of Missouri

    Missouri · 96165

    Office

    $4.83

    Facility

    $3.96

    $0.26 lower than Austin for the office setting.

  • Mississippi

    Mississippi · 96165

    Office

    $4.82

    Facility

    $3.96

    $0.27 lower than Austin for the office setting.

  • Montana**

    Montana · 96165

    Office

    $5.01

    Facility

    $4.01

    $0.08 lower than Austin for the office setting.

  • North Carolina

    North Carolina · 96165

    Office

    $4.92

    Facility

    $3.99

    $0.17 lower than Austin for the office setting.

  • North Dakota**

    North Dakota · 96165

    Office

    $5.01

    Facility

    $4.01

    $0.08 lower than Austin for the office setting.

  • Nebraska

    Nebraska · 96165

    Office

    $4.91

    Facility

    $3.98

    $0.18 lower than Austin for the office setting.

  • New Hampshire

    New Hampshire · 96165

    Office

    $5.06

    Facility

    $4.02

    $0.03 lower than Austin for the office setting.

  • Northern Nj

    New Jersey · 96165

    Office

    $5.46

    Facility

    $4.29

    $0.37 higher than Austin for the office setting.

  • Rest Of New Jersey

    New Jersey · 96165

    Office

    $5.28

    Facility

    $4.19

    $0.19 higher than Austin for the office setting.

  • New Mexico

    New Mexico · 96165

    Office

    $4.90

    Facility

    $3.98

    $0.19 lower than Austin for the office setting.

  • Nevada**

    Nevada · 96165

    Office

    $5.01

    Facility

    $4.01

    $0.08 lower than Austin for the office setting.

  • Nyc Suburbs/Long Island

    New York · 96165

    Office

    $5.50

    Facility

    $4.31

    $0.41 higher than Austin for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 96165

    Office

    $5.30

    Facility

    $4.21

    $0.21 higher than Austin for the office setting.

  • Queens

    New York · 96165

    Office

    $5.49

    Facility

    $4.30

    $0.40 higher than Austin for the office setting.

  • Rest Of New York

    New York · 96165

    Office

    $4.94

    Facility

    $3.99

    $0.15 lower than Austin for the office setting.

  • Ohio

    Ohio · 96165

    Office

    $4.89

    Facility

    $3.98

    $0.20 lower than Austin for the office setting.

  • Oklahoma

    Oklahoma · 96165

    Office

    $4.87

    Facility

    $3.97

    $0.22 lower than Austin for the office setting.

  • Portland

    Oregon · 96165

    Office

    $5.22

    Facility

    $4.10

    $0.13 higher than Austin for the office setting.

  • Rest Of Oregon

    Oregon · 96165

    Office

    $5.00

    Facility

    $4.01

    $0.09 lower than Austin for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 96165

    Office

    $5.13

    Facility

    $4.09

    $0.04 higher than Austin for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 96165

    Office

    $4.90

    Facility

    $3.98

    $0.19 lower than Austin for the office setting.

  • Puerto Rico

    Puerto Rico · 96165

    Office

    $5.02

    Facility

    $4.01

    $0.07 lower than Austin for the office setting.

  • Rhode Island

    Rhode Island · 96165

    Office

    $5.12

    Facility

    $4.09

    $0.03 higher than Austin for the office setting.

  • South Carolina

    South Carolina · 96165

    Office

    $4.91

    Facility

    $3.98

    $0.18 lower than Austin for the office setting.

  • South Dakota**

    South Dakota · 96165

    Office

    $5.01

    Facility

    $4.01

    $0.08 lower than Austin for the office setting.

  • Tennessee

    Tennessee · 96165

    Office

    $4.89

    Facility

    $3.98

    $0.20 lower than Austin for the office setting.

  • Utah

    Utah · 96165

    Office

    $4.93

    Facility

    $3.99

    $0.16 lower than Austin for the office setting.

  • Virginia

    Virginia · 96165

    Office

    $4.99

    Facility

    $4.00

    $0.10 lower than Austin for the office setting.

  • Virgin Islands

    United States Virgin Islands · 96165

    Office

    $5.02

    Facility

    $4.01

    $0.07 lower than Austin for the office setting.

  • Vermont

    Vermont · 96165

    Office

    $5.00

    Facility

    $4.00

    $0.09 lower than Austin for the office setting.

  • Rest Of Washington

    Washington · 96165

    Office

    $5.13

    Facility

    $4.07

    $0.04 higher than Austin for the office setting.

  • Seattle (King Cnty)

    Washington · 96165

    Office

    $5.50

    Facility

    $4.27

    $0.41 higher than Austin for the office setting.

  • Wisconsin

    Wisconsin · 96165

    Office

    $4.95

    Facility

    $3.99

    $0.14 lower than Austin for the office setting.

  • West Virginia

    West Virginia · 96165

    Office

    $4.84

    Facility

    $3.96

    $0.25 lower than Austin for the office setting.

  • Wyoming**

    Wyoming · 96165

    Office

    $5.01

    Facility

    $4.01

    $0.08 lower than Austin for the office setting.

See how rates vary across the country

96165 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$4.82

$6.93

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$6.931
AL$4.841
AR$4.821
AZ$4.971
CA$5.20–$6.0029
CO$5.141
CT$5.191
DC$5.451
DE$5.011
FL$4.95–$5.063
GA$4.87–$5.042
GU$5.191
HI$5.191
IA$4.901
ID$4.901
IL$4.89–$5.074
IN$4.911
KS$4.881
KY$4.861
LA$4.86–$4.932
MA$5.14–$5.422
MD$5.06–$5.453
ME$4.90–$5.002
MI$4.89–$4.962
MN$5.051
MO$4.83–$4.953
MS$4.821
MT$5.011
NC$4.921
ND$5.011
NE$4.911
NH$5.061
NJ$5.28–$5.462
NM$4.901
NV$5.011
NY$4.94–$5.505
OH$4.891
OK$4.871
OR$5.00–$5.222
PA$4.90–$5.132
PR$5.021
RI$5.121
SC$4.911
SD$5.011
TN$4.891
TX$4.89–$5.098
UT$4.931
VA$4.99–$5.452
VI$5.021
VT$5.001
WA$5.13–$5.502
WI$4.951
WV$4.841
WY$5.011

Explore 96165 on the national rate map →

Where does this rate apply?

Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Texas →

Why are the office and facility amounts different?

For 96165 in Austin, the physician’s office rate is $5.09 and the facility-setting rate is $4.03: a difference of $1.06.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 96165 in Austin. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$5.60

$5.09 × 110% = $5.60

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 96165 in Austin.

PPRRVU2026_Oct_nonQPP.csv

12,770

Code
96165
Physician work
0.11
Practice expense
0.04
Malpractice
0.00

GPCI2026.csv

96

Locality
Austin
Physician work
1.002
Practice expense
1.058
Malpractice
0.886
Office / nonfacility calculation for 96165 in Austin
ComponentRVULocality factorAdjusted
Physician work0.11× 1.0020.1102
Practice expense0.04× 1.0580.0423
Malpractice0.00× 0.8860.0000
Total RVUs0.1525
Conversion factor× 33.4009

Office / nonfacility rate, Austin$5.09

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 96165 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.111.002
Practice expense0.041.058
Malpractice00.886

(0.11 × 1.002 + 0.04 × 1.058 + 0 × 0.886) × $33.4009 = $5.09

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work0.111.002
Practice expense0.011.058
Malpractice00.886

(0.11 × 1.002 + 0.01 × 1.058 + 0 × 0.886) × $33.4009 = $4.03

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

96165 · Office / nonfacility

$5.09

Effective 2026-10-01

The base rate is $0.18 higher than on 2025-10-01, moving from $4.91 to $5.09 (3.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $4.91changed to$5.09

    • Conversion factor 32.3465 changed to 33.4009
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.046 changed to 1.058
    • Malpractice GPCI 0.914 changed to 0.886

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $4.91

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$5.09$4.03RVU26D
2026-07-01$5.09$4.03RVU26C
2026-04-01$5.09$4.03RVU26B
2026-01-01$5.09$4.03RVU26A
2025-10-01$4.91$4.23RVU25D
2025-07-01$4.91$4.23RVU25C
2025-04-01$4.91$4.23RVU25B
2025-01-01$4.91$4.23RVU25A

96165 billing questions

Can 96165 be reported by itself?

No. It is an add-on code and must be reported with the primary group intervention code 96164.

How is 96165 different from 96164?

96164 reports the initial group intervention segment; 96165 reports each additional 30-minute segment.

When should the individual intervention codes be used instead?

Use 96158 and 96159 when the health behavior intervention is delivered to one patient rather than a group.

What should the note support?

Document the health-related behavioral goals, the intervention delivered, that it was a group session, and the time supporting the additional segment.

Can 96165 be used for a family intervention?

No. Family intervention services are reported with the family-session code family, such as 96167 and 96168, rather than the group codes.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 96165PPRRVU2026_Oct_nonQPP.csv, line 12,770 (RVU26D)
Geographic factors for AustinGPCI2026.csv, line 96 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet