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CMS RVU26D · Effective 2026-10-01

96168 in Austin

Office / nonfacility

$28.80

Base rate per service

Facility setting

$22.79

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 services

About 96168: Additional family health behavior intervention

Report this add-on for each additional 15 minutes of family health behavior intervention conducted with the patient present after the initial service.

This code represents additional time in a health behavior intervention with the patient and one or more family members or caregivers present. A physician or other qualified health care professional may use the session to help the family support behavior change related to the patient’s health condition, such as following a treatment plan or making health-related lifestyle changes. Sessions may occur in an office or facility setting.

Report this code only with the initial family intervention service, 96167, when the documented service extends beyond its initial time. The record should identify the patient’s health-related concern, the family’s role in the intervention, the work performed, and the time supporting the additional unit or units. CMS classifies 96168 as an add-on code: it is billed only with a primary procedure and paid within that procedure’s global period.

CMS billing rules for 96168

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 RVU0.63 · 74%
  • Practice expense (office) RVU0.21 · 25%
  • Malpractice RVU0.01 · 1%

1.3K

Medicare services in 2024 · #2780 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.

96168 compared with similar codes

Office rates for Austin, from the same CMS release.

96167

Family intervention

Patient present, initial 30 minutes

$79.32

96167 reports the initial family intervention with the patient present; 96168 reports additional time and is used with that primary service.

96171

Hlth bhv ivntj fam w/o pt ea

No office rate

Both report additional family intervention time, but 96171 is for a session without the patient present; 96168 requires the patient’s presence.

96159

Health behavior intervention

Individual, additional time

$25.79

96159 reports additional individual intervention time with the patient, while 96168 is for family intervention with the patient present.

96165

Group intervention

Each additional 30 minutes

$5.09

96165 is for additional group intervention time; 96168 is for additional family intervention time with the patient present.

The same code, a different location

How does Austin compare?

In Beaumont, the office rate for 96168 is $27.74—$1.06 lower than the $28.80 rate in Austin. Both use the same code, release and participation basis.

96168 across payment areas

Same release and payment basis · bars start at $0

  1. Austin · This locality

    $28.80

  2. Beaumont

    $27.74

    $1.06 lower than Austin

  3. Brazoria

    $28.42

    $0.38 lower than Austin

  4. Dallas

    $28.50

    $0.30 lower than Austin

  5. Fort Worth

    $28.44

    $0.36 lower than Austin

  6. Galveston

    $28.45

    $0.35 lower than Austin

  7. Houston

    $28.64

    $0.16 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, 96168 ranges from $27.24 in Arkansas to $39.22 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 · 96168

    Office

    $28.00

    Facility

    $22.61

    $0.80 lower than Austin for the office setting.

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

    California · 96168

    Office

    $30.42

    Facility

    $23.71

    $1.62 higher than Austin for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 96168

    Office

    $30.81

    Facility

    $24.12

    $2.01 higher than Austin for the office setting.

  • Miami

    Florida · 96168

    Office

    $29.19

    Facility

    $23.28

    $0.39 higher than Austin for the office setting.

  • Chicago

    Illinois · 96168

    Office

    $29.01

    Facility

    $23.30

    $0.21 higher than Austin for the office setting.

  • Manhattan

    New York · 96168

    Office

    $31.07

    Facility

    $24.47

    $2.27 higher than Austin for the office setting.

  • Alaska*

    Alaska · 96168

    Office

    $39.22

    Facility

    $33.17

    $10.42 higher than Austin for the office setting.

  • Alabama

    Alabama · 96168

    Office

    $27.37

    Facility

    $22.40

    $1.43 lower than Austin for the office setting.

  • Arkansas

    Arkansas · 96168

    Office

    $27.24

    Facility

    $22.36

    $1.56 lower than Austin for the office setting.

  • Arizona

    Arizona · 96168

    Office

    $28.13

    Facility

    $22.62

    $0.67 lower than Austin for the office setting.

  • Bakersfield

    California · 96168

    Office

    $29.33

    Facility

    $23.11

    $0.53 higher than Austin for the office setting.

  • Chico

    California · 96168

    Office

    $29.27

    Facility

    $23.04

    $0.47 higher than Austin for the office setting.

  • El Centro

    California · 96168

    Office

    $29.27

    Facility

    $23.05

    $0.47 higher than Austin for the office setting.

  • Fresno

    California · 96168

    Office

    $29.27

    Facility

    $23.04

    $0.47 higher than Austin for the office setting.

  • Hanford-Corcoran

    California · 96168

    Office

    $29.27

    Facility

    $23.04

    $0.47 higher than Austin for the office setting.

  • Madera

    California · 96168

    Office

    $29.27

    Facility

    $23.04

    $0.47 higher than Austin for the office setting.

  • Merced

    California · 96168

    Office

    $29.27

    Facility

    $23.04

    $0.47 higher than Austin for the office setting.

  • Modesto

    California · 96168

    Office

    $29.27

    Facility

    $23.04

    $0.47 higher than Austin for the office setting.

  • Napa

    California · 96168

    Office

    $31.78

    Facility

    $24.30

    $2.98 higher than Austin for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 96168

    Office

    $30.13

    Facility

    $23.42

    $1.33 higher than Austin for the office setting.

  • Redding

    California · 96168

    Office

    $29.27

    Facility

    $23.04

    $0.47 higher than Austin for the office setting.

  • Rest Of California

    California · 96168

    Office

    $29.27

    Facility

    $23.04

    $0.47 higher than Austin for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 96168

    Office

    $29.39

    Facility

    $23.17

    $0.59 higher than Austin for the office setting.

  • Sacramento-Roseville-Folsom

    California · 96168

    Office

    $30.14

    Facility

    $23.53

    $1.34 higher than Austin for the office setting.

  • Salinas

    California · 96168

    Office

    $30.00

    Facility

    $23.42

    $1.20 higher than Austin for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 96168

    Office

    $30.24

    Facility

    $23.45

    $1.44 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 96168

    Office

    $33.08

    Facility

    $25.08

    $4.28 higher than Austin for the office setting.

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

    California · 96168

    Office

    $33.07

    Facility

    $25.07

    $4.27 higher than Austin for the office setting.

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

    California · 96168

    Office

    $33.65

    Facility

    $25.46

    $4.85 higher than Austin for the office setting.

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

    California · 96168

    Office

    $33.60

    Facility

    $25.42

    $4.80 higher than Austin for the office setting.

  • San Luis Obispo-Paso Robles

    California · 96168

    Office

    $29.57

    Facility

    $23.10

    $0.77 higher than Austin for the office setting.

  • Santa Cruz-Watsonville

    California · 96168

    Office

    $30.19

    Facility

    $23.29

    $1.39 higher than Austin for the office setting.

  • Santa Maria-Santa Barbara

    California · 96168

    Office

    $29.99

    Facility

    $23.37

    $1.19 higher than Austin for the office setting.

  • Santa Rosa-Petaluma

    California · 96168

    Office

    $30.47

    Facility

    $23.49

    $1.67 higher than Austin for the office setting.

  • Stockton

    California · 96168

    Office

    $29.27

    Facility

    $23.04

    $0.47 higher than Austin for the office setting.

  • Vallejo

    California · 96168

    Office

    $31.77

    Facility

    $24.28

    $2.97 higher than Austin for the office setting.

  • Visalia

    California · 96168

    Office

    $29.27

    Facility

    $23.04

    $0.47 higher than Austin for the office setting.

  • Yuba City

    California · 96168

    Office

    $29.27

    Facility

    $23.04

    $0.47 higher than Austin for the office setting.

  • Colorado

    Colorado · 96168

    Office

    $29.02

    Facility

    $22.98

    $0.22 higher than Austin for the office setting.

  • Connecticut

    Connecticut · 96168

    Office

    $29.42

    Facility

    $23.31

    $0.62 higher than Austin for the office setting.

  • Delaware

    Delaware · 96168

    Office

    $28.38

    Facility

    $22.77

    $0.42 lower than Austin for the office setting.

  • Fort Lauderdale

    Florida · 96168

    Office

    $28.75

    Facility

    $23.00

    $0.05 lower than Austin for the office setting.

  • Rest Of Florida

    Florida · 96168

    Office

    $28.25

    Facility

    $22.82

    $0.55 lower than Austin for the office setting.

  • Atlanta

    Georgia · 96168

    Office

    $28.63

    Facility

    $22.86

    $0.17 lower than Austin for the office setting.

  • Rest Of Georgia

    Georgia · 96168

    Office

    $27.70

    Facility

    $22.63

    $1.10 lower than Austin for the office setting.

  • Hawaii, Guam

    Hawaii · 96168

    Office

    $29.21

    Facility

    $22.76

    $0.41 higher than Austin for the office setting.

  • Iowa

    Iowa · 96168

    Office

    $27.59

    Facility

    $22.40

    $1.21 lower than Austin for the office setting.

  • Idaho

    Idaho · 96168

    Office

    $27.65

    Facility

    $22.43

    $1.15 lower than Austin for the office setting.

  • East St. Louis

    Illinois · 96168

    Office

    $28.17

    Facility

    $22.94

    $0.63 lower than Austin for the office setting.

  • Rest Of Illinois

    Illinois · 96168

    Office

    $27.97

    Facility

    $22.78

    $0.83 lower than Austin for the office setting.

  • Suburban Chicago

    Illinois · 96168

    Office

    $28.99

    Facility

    $23.15

    $0.19 higher than Austin for the office setting.

  • Indiana

    Indiana · 96168

    Office

    $27.71

    Facility

    $22.44

    $1.09 lower than Austin for the office setting.

  • Kansas

    Kansas · 96168

    Office

    $27.55

    Facility

    $22.42

    $1.25 lower than Austin for the office setting.

  • Kentucky

    Kentucky · 96168

    Office

    $27.58

    Facility

    $22.54

    $1.22 lower than Austin for the office setting.

  • New Orleans

    Louisiana · 96168

    Office

    $28.02

    Facility

    $22.68

    $0.78 lower than Austin for the office setting.

  • Rest Of Louisiana

    Louisiana · 96168

    Office

    $27.57

    Facility

    $22.54

    $1.23 lower than Austin for the office setting.

  • Metropolitan Boston

    Massachusetts · 96168

    Office

    $30.58

    Facility

    $23.80

    $1.78 higher than Austin for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 96168

    Office

    $29.03

    Facility

    $23.05

    $0.23 higher than Austin for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 96168

    Office

    $29.32

    Facility

    $23.23

    $0.52 higher than Austin for the office setting.

  • Rest Of Maryland

    Maryland · 96168

    Office

    $28.66

    Facility

    $22.91

    $0.14 lower than Austin for the office setting.

  • Rest Of Maine

    Maine · 96168

    Office

    $27.70

    Facility

    $22.48

    $1.10 lower than Austin for the office setting.

  • Southern Maine

    Maine · 96168

    Office

    $28.20

    Facility

    $22.58

    $0.60 lower than Austin for the office setting.

  • Detroit

    Michigan · 96168

    Office

    $28.37

    Facility

    $22.89

    $0.43 lower than Austin for the office setting.

  • Rest Of Michigan

    Michigan · 96168

    Office

    $27.82

    Facility

    $22.64

    $0.98 lower than Austin for the office setting.

  • Minnesota

    Minnesota · 96168

    Office

    $28.36

    Facility

    $22.52

    $0.44 lower than Austin for the office setting.

  • Metropolitan Kansas City

    Missouri · 96168

    Office

    $27.96

    Facility

    $22.62

    $0.84 lower than Austin for the office setting.

  • Metropolitan St. Louis

    Missouri · 96168

    Office

    $28.05

    Facility

    $22.65

    $0.75 lower than Austin for the office setting.

  • Rest Of Missouri

    Missouri · 96168

    Office

    $27.41

    Facility

    $22.52

    $1.39 lower than Austin for the office setting.

  • Mississippi

    Mississippi · 96168

    Office

    $27.33

    Facility

    $22.44

    $1.47 lower than Austin for the office setting.

  • Montana**

    Montana · 96168

    Office

    $28.39

    Facility

    $22.71

    $0.41 lower than Austin for the office setting.

  • North Carolina

    North Carolina · 96168

    Office

    $27.80

    Facility

    $22.50

    $1.00 lower than Austin for the office setting.

  • North Dakota**

    North Dakota · 96168

    Office

    $28.19

    Facility

    $22.51

    $0.61 lower than Austin for the office setting.

  • Nebraska

    Nebraska · 96168

    Office

    $27.64

    Facility

    $22.40

    $1.16 lower than Austin for the office setting.

  • New Hampshire

    New Hampshire · 96168

    Office

    $28.64

    Facility

    $22.73

    $0.16 lower than Austin for the office setting.

  • Northern Nj

    New Jersey · 96168

    Office

    $30.86

    Facility

    $24.27

    $2.06 higher than Austin for the office setting.

  • Rest Of New Jersey

    New Jersey · 96168

    Office

    $29.91

    Facility

    $23.71

    $1.11 higher than Austin for the office setting.

  • New Mexico

    New Mexico · 96168

    Office

    $27.88

    Facility

    $22.67

    $0.92 lower than Austin for the office setting.

  • Nevada**

    Nevada · 96168

    Office

    $28.34

    Facility

    $22.66

    $0.46 lower than Austin for the office setting.

  • Nyc Suburbs/Long Island

    New York · 96168

    Office

    $31.35

    Facility

    $24.60

    $2.55 higher than Austin for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 96168

    Office

    $30.07

    Facility

    $23.86

    $1.27 higher than Austin for the office setting.

  • Queens

    New York · 96168

    Office

    $31.16

    Facility

    $24.45

    $2.36 higher than Austin for the office setting.

  • Rest Of New York

    New York · 96168

    Office

    $27.94

    Facility

    $22.55

    $0.86 lower than Austin for the office setting.

  • Ohio

    Ohio · 96168

    Office

    $27.78

    Facility

    $22.60

    $1.02 lower than Austin for the office setting.

  • Oklahoma

    Oklahoma · 96168

    Office

    $27.57

    Facility

    $22.50

    $1.23 lower than Austin for the office setting.

  • Portland

    Oregon · 96168

    Office

    $29.42

    Facility

    $23.11

    $0.62 higher than Austin for the office setting.

  • Rest Of Oregon

    Oregon · 96168

    Office

    $28.26

    Facility

    $22.61

    $0.54 lower than Austin for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 96168

    Office

    $29.12

    Facility

    $23.21

    $0.32 higher than Austin for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 96168

    Office

    $27.80

    Facility

    $22.58

    $1.00 lower than Austin for the office setting.

  • Puerto Rico

    Puerto Rico · 96168

    Office

    $28.46

    Facility

    $22.72

    $0.34 lower than Austin for the office setting.

  • Rhode Island

    Rhode Island · 96168

    Office

    $28.99

    Facility

    $23.12

    $0.19 higher than Austin for the office setting.

  • South Carolina

    South Carolina · 96168

    Office

    $27.81

    Facility

    $22.56

    $0.99 lower than Austin for the office setting.

  • South Dakota**

    South Dakota · 96168

    Office

    $28.17

    Facility

    $22.49

    $0.63 lower than Austin for the office setting.

  • Tennessee

    Tennessee · 96168

    Office

    $27.60

    Facility

    $22.44

    $1.20 lower than Austin for the office setting.

  • Utah

    Utah · 96168

    Office

    $27.94

    Facility

    $22.60

    $0.86 lower than Austin for the office setting.

  • Virginia

    Virginia · 96168

    Office

    $28.17

    Facility

    $22.59

    $0.63 lower than Austin for the office setting.

  • Virgin Islands

    United States Virgin Islands · 96168

    Office

    $28.46

    Facility

    $22.72

    $0.34 lower than Austin for the office setting.

  • Vermont

    Vermont · 96168

    Office

    $28.16

    Facility

    $22.53

    $0.64 lower than Austin for the office setting.

  • Rest Of Washington

    Washington · 96168

    Office

    $28.96

    Facility

    $22.98

    $0.16 higher than Austin for the office setting.

  • Seattle (King Cnty)

    Washington · 96168

    Office

    $30.97

    Facility

    $24.01

    $2.17 higher than Austin for the office setting.

  • Wisconsin

    Wisconsin · 96168

    Office

    $27.87

    Facility

    $22.43

    $0.93 lower than Austin for the office setting.

  • West Virginia

    West Virginia · 96168

    Office

    $27.62

    Facility

    $22.68

    $1.18 lower than Austin for the office setting.

  • Wyoming**

    Wyoming · 96168

    Office

    $28.30

    Facility

    $22.63

    $0.50 lower than Austin for the office setting.

See how rates vary across the country

96168 · 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.

$27.24

$39.22

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$39.221
AL$27.371
AR$27.241
AZ$28.131
CA$29.27–$33.6529
CO$29.021
CT$29.421
DC$30.811
DE$28.381
FL$28.25–$29.193
GA$27.70–$28.632
GU$29.211
HI$29.211
IA$27.591
ID$27.651
IL$27.97–$29.014
IN$27.711
KS$27.551
KY$27.581
LA$27.57–$28.022
MA$29.03–$30.582
MD$28.66–$30.813
ME$27.70–$28.202
MI$27.82–$28.372
MN$28.361
MO$27.41–$28.053
MS$27.331
MT$28.391
NC$27.801
ND$28.191
NE$27.641
NH$28.641
NJ$29.91–$30.862
NM$27.881
NV$28.341
NY$27.94–$31.355
OH$27.781
OK$27.571
OR$28.26–$29.422
PA$27.80–$29.122
PR$28.461
RI$28.991
SC$27.811
SD$28.171
TN$27.601
TX$27.74–$28.808
UT$27.941
VA$28.17–$30.812
VI$28.461
VT$28.161
WA$28.96–$30.972
WI$27.871
WV$27.621
WY$28.301

Explore 96168 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 96168 in Austin, the physician’s office rate is $28.80 and the facility-setting rate is $22.79: a difference of $6.01.

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 96168 in Austin. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$31.68

$28.80 × 110% = $31.68

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.

Compare your contract offer →

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 96168 in Austin.

PPRRVU2026_Oct_nonQPP.csv

12,772

Code
96168
Physician work
0.63
Practice expense
0.21
Malpractice
0.01

GPCI2026.csv

96

Locality
Austin
Physician work
1.002
Practice expense
1.058
Malpractice
0.886
Office / nonfacility calculation for 96168 in Austin
ComponentRVULocality factorAdjusted
Physician work0.63× 1.0020.6313
Practice expense0.21× 1.0580.2222
Malpractice0.01× 0.8860.0089
Total RVUs0.8623
Conversion factor× 33.4009

Office / nonfacility rate, Austin$28.80

Open 96168 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.631.002
Practice expense0.211.058
Malpractice0.010.886

(0.63 × 1.002 + 0.21 × 1.058 + 0.01 × 0.886) × $33.4009 = $28.80

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work0.631.002
Practice expense0.041.058
Malpractice0.010.886

(0.63 × 1.002 + 0.04 × 1.058 + 0.01 × 0.886) × $33.4009 = $22.79

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

96168 · Office / nonfacility

$28.80

Effective 2026-10-01

The base rate is $2.71 higher than on 2025-10-01, moving from $26.09 to $28.80 (10.4%).

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

    $26.09changed to$28.80

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.60 changed to 0.63
    • Practice expense RVU 0.18 changed to 0.21
    • Malpractice RVU 0.02 changed to 0.01
    • 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: $26.09

    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$28.80$22.79RVU26D
2026-07-01$28.80$22.79RVU26C
2026-04-01$28.80$22.79RVU26B
2026-01-01$28.80$22.79RVU26A
2025-10-01$26.09$22.71RVU25D
2025-07-01$26.09$22.71RVU25C
2025-04-01$26.09$22.71RVU25B
2025-01-01$26.09$22.71RVU25A

96168 billing questions

When is 96168 reported with 96167?

Use 96167 for the initial family intervention and 96168 for each additional 15 minutes of qualifying intervention time. The patient must be present for this family-service code.

Can 96168 be billed by itself?

No. It is an add-on code and must be reported with its primary family intervention service, 96167.

How does 96168 differ from 96171?

96168 is for additional family intervention time with the patient present. 96171 is for additional family intervention time when the patient is not present.

What should the documentation support?

Document the health behavior concern, the patient’s presence, the family’s participation, the intervention provided, and the time supporting the additional service.

Can 96168 be used for an individual session?

No. For additional health behavior intervention time provided individually to the patient, consider 96159 rather than this family-service add-on.

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 96168PPRRVU2026_Oct_nonQPP.csv, line 12,772 (RVU26D)
Geographic factors for AustinGPCI2026.csv, line 96 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet