$76.20
96167 reports the initial family intervention with the patient present; 96168 reports additional time and is used with that primary service.
On this page
CMS RVU26D · Effective 2026-10-01
96168 Family intervention Medicare reimbursement rates in Kansas
Report this add-on for each additional 15 minutes of family health behavior intervention conducted with the patient present after the initial service. Compare 96168 office and facility rates across CMS payment localities in Kansas.
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.
What does Medicare pay for 96168 in Kansas?
Kansas has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$27.55
1 of 1 localities have a supported rate.
Payment area: Kansas
One mapped payment locality.
Facility setting
$22.42
1 of 1 localities have a supported rate.
Payment area: Kansas
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
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 Kansas, from the same CMS release.
96171
No office rateHlth bhv ivntj fam w/o pt ea
Both report additional family intervention time, but 96171 is for a session without the patient present; 96168 requires the patient’s presence.
$24.78
96159 reports additional individual intervention time with the patient, while 96168 is for family intervention with the patient present.
$4.88
96165 is for additional group intervention time; 96168 is for additional family intervention time with the patient present.
Compare 96168 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Kansas →
Office / nonfacility
$27.55
Facility
$22.42
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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 96168 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
12,772
- Code
- 96168
- Physician work
- 0.63
- Practice expense
- 0.21
- Malpractice
- 0.01
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.63 | × 1.000 | 0.6300 |
| Practice expense | 0.21 | × 0.904 | 0.1898 |
| Malpractice | 0.01 | × 0.504 | 0.0050 |
| Total RVUs | 0.8249 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kansas$27.55
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.63 | 1 |
| Practice expense | 0.21 | 0.904 |
| Malpractice | 0.01 | 0.504 |
(0.63 × 1 + 0.21 × 0.904 + 0.01 × 0.504) × $33.4009 = $27.55
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.63 | 1 |
| Practice expense | 0.04 | 0.904 |
| Malpractice | 0.01 | 0.504 |
(0.63 × 1 + 0.04 × 0.904 + 0.01 × 0.504) × $33.4009 = $22.42
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.
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.
12,76996164,,Hlth bhv ivntj grp 1st 30,A,,0.24,0.10,,0.03,,0.01,0.35,0.28,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,77096165,,Hlth bhv ivntj grp ea addl,A,,0.11,0.04,,0.01,,0.00,0.15,0.12,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,77196167,,Hlth bhv ivntj fam 1st 30,A,,1.77,0.56,,0.11,,0.01,2.34,1.89,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,77296168,,Hlth bhv ivntj fam ea addl,A,,0.63,0.21,,0.04,,0.01,0.85,0.68,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,77396170,,Hlth bhv ivntj fam wo pt 1st,N,+,1.50,0.66,,0.33,,0.08,2.24,1.91,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
12,77496171,,Hlth bhv ivntj fam w/o pt ea,N,+,0.54,0.24,,0.12,,0.03,0.81,0.69,9,ZZZ,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
12,77596202,,Mlt fam grp bhv train 1st 60,A,,0.43,0.16,,0.08,,0.01,0.60,0.52,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958