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CMS RVU26D · Effective 2026-10-01

96160 in Wyoming**

Office / nonfacility

$3.01

Base rate per service

Facility setting

Not available in this setting

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 assessment

About 96160: Patient-focused health risk assessment

Report this service for administering and documenting a standardized instrument that assesses a patient’s health risks, alongside a qualifying primary procedure.

This service covers a standardized instrument focused on the patient’s health risks, such as a health hazard appraisal, including the instrument’s scoring and documentation. The patient may complete the questions during a physician-office encounter, with practice staff administering or scoring the instrument under physician supervision when the service is billed incident-to.

Select this code when the documented service is a patient-focused risk instrument, rather than a clinician’s broader health behavior assessment or a brief emotional or behavioral screen. Keep the instrument, score, and resulting documentation in the record. CMS treats the code as an add-on: report it only with a primary procedure, and payment falls within that procedure’s global period. CMS assigns zero work and malpractice RVUs, with practice-expense RVUs in both office and facility settings.

CMS billing rules for 96160

Global period
Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Professional and technical components
Incident-to service: billed only when performed under physician supervision.

Where the value comes from

  • Work RVU0.00 · 0%
  • Practice expense (office) RVU0.09 · 100%
  • Malpractice RVU0.00 · 0%

214.3K

Medicare services in 2024 · #372 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.

96160 compared with similar codes

Office rates for Wyoming**, from the same CMS release.

96161

Health risk assessment

Caregiver-focused instrument

$3.34

Choose 96160 when the instrument assesses the patient’s health risks; choose 96161 when it assesses the caregiver’s health risks.

96127

Behavioral screening tool

Per scored standardized instrument

$4.92

96127 is for a brief emotional or behavioral assessment. 96160 addresses patient-focused health risks using a standardized instrument.

96156

Health behavior assessment

Assessment or reassessment

$107.38

96156 describes a health behavior assessment or reassessment; 96160 covers administration, scoring, and documentation of a patient-focused risk instrument.

The same code, a different location

How does Wyoming** compare?

96160 across payment areas

Same release and payment basis · bars start at $0

  1. Wyoming** · This locality

    $3.01

  2. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $3.56

    $0.55 higher than Wyoming**

  3. Dc + Md/Va Suburbs

    $3.54

    $0.53 higher than Wyoming**

  4. Miami

    $3.13

    $0.12 higher than Wyoming**

  5. Chicago

    $3.02

    $0.01 higher than Wyoming**

  6. Manhattan

    $3.49

    $0.48 higher than Wyoming**

  7. Alaska*

    $3.20

    $0.19 higher than Wyoming**

Other payment areas listed in Wyoming 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, 96160 ranges from $2.58 in Arkansas to $4.33 in San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty). 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

  • Alabama

    Alabama · 96160

    Office

    $2.63

    Facility

    Unavailable

    $0.38 lower than Wyoming** for the office setting.

  • Arkansas

    Arkansas · 96160

    Office

    $2.58

    Facility

    Unavailable

    $0.43 lower than Wyoming** for the office setting.

  • Arizona

    Arizona · 96160

    Office

    $2.91

    Facility

    Unavailable

    $0.10 lower than Wyoming** for the office setting.

  • Bakersfield

    California · 96160

    Office

    $3.29

    Facility

    Unavailable

    $0.28 higher than Wyoming** for the office setting.

  • Chico

    California · 96160

    Office

    $3.29

    Facility

    Unavailable

    $0.28 higher than Wyoming** for the office setting.

  • El Centro

    California · 96160

    Office

    $3.29

    Facility

    Unavailable

    $0.28 higher than Wyoming** for the office setting.

  • Fresno

    California · 96160

    Office

    $3.29

    Facility

    Unavailable

    $0.28 higher than Wyoming** for the office setting.

  • Hanford-Corcoran

    California · 96160

    Office

    $3.29

    Facility

    Unavailable

    $0.28 higher than Wyoming** for the office setting.

  • Madera

    California · 96160

    Office

    $3.29

    Facility

    Unavailable

    $0.28 higher than Wyoming** for the office setting.

  • Merced

    California · 96160

    Office

    $3.29

    Facility

    Unavailable

    $0.28 higher than Wyoming** for the office setting.

  • Modesto

    California · 96160

    Office

    $3.29

    Facility

    Unavailable

    $0.28 higher than Wyoming** for the office setting.

  • Napa

    California · 96160

    Office

    $3.96

    Facility

    Unavailable

    $0.95 higher than Wyoming** for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 96160

    Office

    $3.55

    Facility

    Unavailable

    $0.54 higher than Wyoming** for the office setting.

  • Redding

    California · 96160

    Office

    $3.29

    Facility

    Unavailable

    $0.28 higher than Wyoming** for the office setting.

  • Rest Of California

    California · 96160

    Office

    $3.29

    Facility

    Unavailable

    $0.28 higher than Wyoming** for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 96160

    Office

    $3.29

    Facility

    Unavailable

    $0.28 higher than Wyoming** for the office setting.

  • Sacramento-Roseville-Folsom

    California · 96160

    Office

    $3.50

    Facility

    Unavailable

    $0.49 higher than Wyoming** for the office setting.

  • Salinas

    California · 96160

    Office

    $3.48

    Facility

    Unavailable

    $0.47 higher than Wyoming** for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 96160

    Office

    $3.60

    Facility

    Unavailable

    $0.59 higher than Wyoming** for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 96160

    Office

    $4.24

    Facility

    Unavailable

    $1.23 higher than Wyoming** for the office setting.

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

    California · 96160

    Office

    $4.24

    Facility

    Unavailable

    $1.23 higher than Wyoming** for the office setting.

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

    California · 96160

    Office

    $4.33

    Facility

    Unavailable

    $1.32 higher than Wyoming** for the office setting.

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

    California · 96160

    Office

    $4.33

    Facility

    Unavailable

    $1.32 higher than Wyoming** for the office setting.

  • San Luis Obispo-Paso Robles

    California · 96160

    Office

    $3.42

    Facility

    Unavailable

    $0.41 higher than Wyoming** for the office setting.

  • Santa Cruz-Watsonville

    California · 96160

    Office

    $3.65

    Facility

    Unavailable

    $0.64 higher than Wyoming** for the office setting.

  • Santa Maria-Santa Barbara

    California · 96160

    Office

    $3.51

    Facility

    Unavailable

    $0.50 higher than Wyoming** for the office setting.

  • Santa Rosa-Petaluma

    California · 96160

    Office

    $3.69

    Facility

    Unavailable

    $0.68 higher than Wyoming** for the office setting.

  • Stockton

    California · 96160

    Office

    $3.29

    Facility

    Unavailable

    $0.28 higher than Wyoming** for the office setting.

  • Vallejo

    California · 96160

    Office

    $3.96

    Facility

    Unavailable

    $0.95 higher than Wyoming** for the office setting.

  • Visalia

    California · 96160

    Office

    $3.29

    Facility

    Unavailable

    $0.28 higher than Wyoming** for the office setting.

  • Yuba City

    California · 96160

    Office

    $3.29

    Facility

    Unavailable

    $0.28 higher than Wyoming** for the office setting.

  • Colorado

    Colorado · 96160

    Office

    $3.20

    Facility

    Unavailable

    $0.19 higher than Wyoming** for the office setting.

  • Connecticut

    Connecticut · 96160

    Office

    $3.24

    Facility

    Unavailable

    $0.23 higher than Wyoming** for the office setting.

  • Delaware

    Delaware · 96160

    Office

    $2.97

    Facility

    Unavailable

    $0.04 lower than Wyoming** for the office setting.

  • Fort Lauderdale

    Florida · 96160

    Office

    $3.05

    Facility

    Unavailable

    $0.04 higher than Wyoming** for the office setting.

  • Rest Of Florida

    Florida · 96160

    Office

    $2.87

    Facility

    Unavailable

    $0.14 lower than Wyoming** for the office setting.

  • Atlanta

    Georgia · 96160

    Office

    $3.05

    Facility

    Unavailable

    $0.04 higher than Wyoming** for the office setting.

  • Rest Of Georgia

    Georgia · 96160

    Office

    $2.68

    Facility

    Unavailable

    $0.33 lower than Wyoming** for the office setting.

  • Hawaii, Guam

    Hawaii · 96160

    Office

    $3.42

    Facility

    Unavailable

    $0.41 higher than Wyoming** for the office setting.

  • Iowa

    Iowa · 96160

    Office

    $2.75

    Facility

    Unavailable

    $0.26 lower than Wyoming** for the office setting.

  • Idaho

    Idaho · 96160

    Office

    $2.77

    Facility

    Unavailable

    $0.24 lower than Wyoming** for the office setting.

  • East St. Louis

    Illinois · 96160

    Office

    $2.77

    Facility

    Unavailable

    $0.24 lower than Wyoming** for the office setting.

  • Rest Of Illinois

    Illinois · 96160

    Office

    $2.74

    Facility

    Unavailable

    $0.27 lower than Wyoming** for the office setting.

  • Suburban Chicago

    Illinois · 96160

    Office

    $3.09

    Facility

    Unavailable

    $0.08 higher than Wyoming** for the office setting.

  • Indiana

    Indiana · 96160

    Office

    $2.79

    Facility

    Unavailable

    $0.22 lower than Wyoming** for the office setting.

  • Kansas

    Kansas · 96160

    Office

    $2.72

    Facility

    Unavailable

    $0.29 lower than Wyoming** for the office setting.

  • Kentucky

    Kentucky · 96160

    Office

    $2.67

    Facility

    Unavailable

    $0.34 lower than Wyoming** for the office setting.

  • New Orleans

    Louisiana · 96160

    Office

    $2.83

    Facility

    Unavailable

    $0.18 lower than Wyoming** for the office setting.

  • Rest Of Louisiana

    Louisiana · 96160

    Office

    $2.66

    Facility

    Unavailable

    $0.35 lower than Wyoming** for the office setting.

  • Metropolitan Boston

    Massachusetts · 96160

    Office

    $3.59

    Facility

    Unavailable

    $0.58 higher than Wyoming** for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 96160

    Office

    $3.17

    Facility

    Unavailable

    $0.16 higher than Wyoming** for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 96160

    Office

    $3.23

    Facility

    Unavailable

    $0.22 higher than Wyoming** for the office setting.

  • Rest Of Maryland

    Maryland · 96160

    Office

    $3.04

    Facility

    Unavailable

    $0.03 higher than Wyoming** for the office setting.

  • Rest Of Maine

    Maine · 96160

    Office

    $2.77

    Facility

    Unavailable

    $0.24 lower than Wyoming** for the office setting.

  • Southern Maine

    Maine · 96160

    Office

    $2.98

    Facility

    Unavailable

    $0.03 lower than Wyoming** for the office setting.

  • Detroit

    Michigan · 96160

    Office

    $2.90

    Facility

    Unavailable

    $0.11 lower than Wyoming** for the office setting.

  • Rest Of Michigan

    Michigan · 96160

    Office

    $2.74

    Facility

    Unavailable

    $0.27 lower than Wyoming** for the office setting.

  • Minnesota

    Minnesota · 96160

    Office

    $3.09

    Facility

    Unavailable

    $0.08 higher than Wyoming** for the office setting.

  • Metropolitan Kansas City

    Missouri · 96160

    Office

    $2.82

    Facility

    Unavailable

    $0.19 lower than Wyoming** for the office setting.

  • Metropolitan St. Louis

    Missouri · 96160

    Office

    $2.86

    Facility

    Unavailable

    $0.15 lower than Wyoming** for the office setting.

  • Rest Of Missouri

    Missouri · 96160

    Office

    $2.59

    Facility

    Unavailable

    $0.42 lower than Wyoming** for the office setting.

  • Mississippi

    Mississippi · 96160

    Office

    $2.59

    Facility

    Unavailable

    $0.42 lower than Wyoming** for the office setting.

  • Montana**

    Montana · 96160

    Office

    $3.01

    Facility

    Unavailable

    The same base rate than Wyoming** for the office setting.

  • North Carolina

    North Carolina · 96160

    Office

    $2.80

    Facility

    Unavailable

    $0.21 lower than Wyoming** for the office setting.

  • North Dakota**

    North Dakota · 96160

    Office

    $3.01

    Facility

    Unavailable

    The same base rate than Wyoming** for the office setting.

  • Nebraska

    Nebraska · 96160

    Office

    $2.77

    Facility

    Unavailable

    $0.24 lower than Wyoming** for the office setting.

  • New Hampshire

    New Hampshire · 96160

    Office

    $3.13

    Facility

    Unavailable

    $0.12 higher than Wyoming** for the office setting.

  • Northern Nj

    New Jersey · 96160

    Office

    $3.49

    Facility

    Unavailable

    $0.48 higher than Wyoming** for the office setting.

  • Rest Of New Jersey

    New Jersey · 96160

    Office

    $3.28

    Facility

    Unavailable

    $0.27 higher than Wyoming** for the office setting.

  • New Mexico

    New Mexico · 96160

    Office

    $2.76

    Facility

    Unavailable

    $0.25 lower than Wyoming** for the office setting.

  • Nevada**

    Nevada · 96160

    Office

    $3.01

    Facility

    Unavailable

    The same base rate than Wyoming** for the office setting.

  • Nyc Suburbs/Long Island

    New York · 96160

    Office

    $3.57

    Facility

    Unavailable

    $0.56 higher than Wyoming** for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 96160

    Office

    $3.29

    Facility

    Unavailable

    $0.28 higher than Wyoming** for the office setting.

  • Queens

    New York · 96160

    Office

    $3.55

    Facility

    Unavailable

    $0.54 higher than Wyoming** for the office setting.

  • Rest Of New York

    New York · 96160

    Office

    $2.86

    Facility

    Unavailable

    $0.15 lower than Wyoming** for the office setting.

  • Ohio

    Ohio · 96160

    Office

    $2.74

    Facility

    Unavailable

    $0.27 lower than Wyoming** for the office setting.

  • Oklahoma

    Oklahoma · 96160

    Office

    $2.68

    Facility

    Unavailable

    $0.33 lower than Wyoming** for the office setting.

  • Portland

    Oregon · 96160

    Office

    $3.34

    Facility

    Unavailable

    $0.33 higher than Wyoming** for the office setting.

  • Rest Of Oregon

    Oregon · 96160

    Office

    $2.99

    Facility

    Unavailable

    $0.02 lower than Wyoming** for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 96160

    Office

    $3.13

    Facility

    Unavailable

    $0.12 higher than Wyoming** for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 96160

    Office

    $2.76

    Facility

    Unavailable

    $0.25 lower than Wyoming** for the office setting.

  • Puerto Rico

    Puerto Rico · 96160

    Office

    $3.04

    Facility

    Unavailable

    $0.03 higher than Wyoming** for the office setting.

  • Rhode Island

    Rhode Island · 96160

    Office

    $3.11

    Facility

    Unavailable

    $0.10 higher than Wyoming** for the office setting.

  • South Carolina

    South Carolina · 96160

    Office

    $2.78

    Facility

    Unavailable

    $0.23 lower than Wyoming** for the office setting.

  • South Dakota**

    South Dakota · 96160

    Office

    $3.01

    Facility

    Unavailable

    The same base rate than Wyoming** for the office setting.

  • Tennessee

    Tennessee · 96160

    Office

    $2.73

    Facility

    Unavailable

    $0.28 lower than Wyoming** for the office setting.

  • Austin

    Texas · 96160

    Office

    $3.18

    Facility

    Unavailable

    $0.17 higher than Wyoming** for the office setting.

  • Beaumont

    Texas · 96160

    Office

    $2.74

    Facility

    Unavailable

    $0.27 lower than Wyoming** for the office setting.

  • Brazoria

    Texas · 96160

    Office

    $2.98

    Facility

    Unavailable

    $0.03 lower than Wyoming** for the office setting.

  • Dallas

    Texas · 96160

    Office

    $2.99

    Facility

    Unavailable

    $0.02 lower than Wyoming** for the office setting.

  • Fort Worth

    Texas · 96160

    Office

    $2.96

    Facility

    Unavailable

    $0.05 lower than Wyoming** for the office setting.

  • Galveston

    Texas · 96160

    Office

    $2.99

    Facility

    Unavailable

    $0.02 lower than Wyoming** for the office setting.

  • Houston

    Texas · 96160

    Office

    $2.99

    Facility

    Unavailable

    $0.02 lower than Wyoming** for the office setting.

  • Rest Of Texas

    Texas · 96160

    Office

    $2.85

    Facility

    Unavailable

    $0.16 lower than Wyoming** for the office setting.

  • Utah

    Utah · 96160

    Office

    $2.83

    Facility

    Unavailable

    $0.18 lower than Wyoming** for the office setting.

  • Virginia

    Virginia · 96160

    Office

    $2.95

    Facility

    Unavailable

    $0.06 lower than Wyoming** for the office setting.

  • Virgin Islands

    United States Virgin Islands · 96160

    Office

    $3.04

    Facility

    Unavailable

    $0.03 higher than Wyoming** for the office setting.

  • Vermont

    Vermont · 96160

    Office

    $2.98

    Facility

    Unavailable

    $0.03 lower than Wyoming** for the office setting.

  • Rest Of Washington

    Washington · 96160

    Office

    $3.17

    Facility

    Unavailable

    $0.16 higher than Wyoming** for the office setting.

  • Seattle (King Cnty)

    Washington · 96160

    Office

    $3.69

    Facility

    Unavailable

    $0.68 higher than Wyoming** for the office setting.

  • Wisconsin

    Wisconsin · 96160

    Office

    $2.88

    Facility

    Unavailable

    $0.13 lower than Wyoming** for the office setting.

  • West Virginia

    West Virginia · 96160

    Office

    $2.61

    Facility

    Unavailable

    $0.40 lower than Wyoming** for the office setting.

See how rates vary across the country

96160 · 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.

$2.58

$3.81

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$3.201
AL$2.631
AR$2.581
AZ$2.911
CA$3.29–$4.3329
CO$3.201
CT$3.241
DC$3.541
DE$2.971
FL$2.87–$3.133
GA$2.68–$3.052
GU$3.421
HI$3.421
IA$2.751
ID$2.771
IL$2.74–$3.094
IN$2.791
KS$2.721
KY$2.671
LA$2.66–$2.832
MA$3.17–$3.592
MD$3.04–$3.543
ME$2.77–$2.982
MI$2.74–$2.902
MN$3.091
MO$2.59–$2.863
MS$2.591
MT$3.011
NC$2.801
ND$3.011
NE$2.771
NH$3.131
NJ$3.28–$3.492
NM$2.761
NV$3.011
NY$2.86–$3.575
OH$2.741
OK$2.681
OR$2.99–$3.342
PA$2.76–$3.132
PR$3.041
RI$3.111
SC$2.781
SD$3.011
TN$2.731
TX$2.74–$3.188
UT$2.831
VA$2.95–$3.542
VI$3.041
VT$2.981
WA$3.17–$3.692
WI$2.881
WV$2.611
WY$3.011

Explore 96160 on the national rate map →

Where does this rate apply?

Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, 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 Wyoming →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 96160 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$3.31

$3.01 × 110% = $3.31

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 96160 in Wyoming**.

PPRRVU2026_Oct_nonQPP.csv

12,767

Code
96160
Physician work
0.00
Practice expense
0.09
Malpractice
0.00

GPCI2026.csv

112

Locality
Wyoming**
Physician work
1.000
Practice expense
1.000
Malpractice
0.740
Office / nonfacility calculation for 96160 in Wyoming**
ComponentRVULocality factorAdjusted
Physician work0.00× 1.0000.0000
Practice expense0.09× 1.0000.0900
Malpractice0.00× 0.7400.0000
Total RVUs0.0900
Conversion factor× 33.4009

Office / nonfacility rate, Wyoming**$3.01

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

Open 96160 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work01
Practice expense0.091
Malpractice00.74

(0 × 1 + 0.09 × 1 + 0 × 0.74) × $33.4009 = $3.01

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

96160 · Office / nonfacility

$3.01

Effective 2026-10-01

The base rate is $0.10 higher than on 2025-10-01, moving from $2.91 to $3.01 (3.4%).

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

    $2.91changed to$3.01

    • Conversion factor 32.3465 changed to 33.4009
    • Malpractice GPCI 0.739 changed to 0.740

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $2.91

    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$3.01Not available in this settingRVU26D
2026-07-01$3.01Not available in this settingRVU26C
2026-04-01$3.01Not available in this settingRVU26B
2026-01-01$3.01Not available in this settingRVU26A
2025-10-01$2.91Not available in this settingRVU25D
2025-07-01$2.91Not available in this settingRVU25C
2025-04-01$2.91Not available in this settingRVU25B
2025-01-01$2.91Not available in this settingRVU25A

96160 billing questions

Can 96160 be billed by itself?

No. CMS identifies it as an add-on code, so the claim must include a primary procedure; payment falls within that procedure’s global period.

What documentation supports 96160?

Document the standardized patient-focused risk instrument, its administration, the score, and the resulting assessment information.

Can practice staff administer or score the instrument?

The service may be billed incident-to only when performed under physician supervision.

How is 96160 different from 96127?

96160 concerns a patient-focused health risk instrument. 96127 is for a brief emotional or behavioral assessment.

Is 96160 interchangeable with a caregiver risk assessment?

No. 96160 is focused on the patient; 96161 is the related code for a caregiver-focused health risk assessment.

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 96160PPRRVU2026_Oct_nonQPP.csv, line 12,767 (RVU26D)
Geographic factors for Wyoming**GPCI2026.csv, line 112 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet