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CMS RVU26D · Effective 2026-10-01

96167 Family intervention Medicare reimbursement rates in Missouri

Report this service for a timed health behavior intervention focused on the patient’s health needs and delivered with the patient and family together. Compare 96167 office and facility rates across CMS payment localities in Missouri.

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 96167 in Missouri?

Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.

Office / nonfacility

$75.57–$77.26

3 of 3 localities have a supported rate.

Lowest: Rest Of Missouri

Highest: Metropolitan St. Louis

A spread of $1.69 per service.

Facility setting

$62.61–$62.95

3 of 3 localities have a supported rate.

Lowest: Rest Of Missouri

Highest: Metropolitan St. Louis

A spread of $0.34 per service.

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.

Find 96167 in your payment locality →

Where 96167 pays more and less in Missouri

3 payment localities

$75.57 to $77.26

$75.57$76.41$77.26
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

Health behavior intervention

About 96167: Family health behavior intervention with patient

Report this service for a timed health behavior intervention focused on the patient’s health needs and delivered with the patient and family together.

A clinician works with the patient and one or more family members to address health-related behaviors, coping, adherence, or self-management. The discussion and intervention focus on the patient’s medical condition or health goals, rather than providing family psychotherapy. Physicians and other qualified health care professionals may provide this service in office or facility settings when the patient participates with family members.

Use 96167 for the initial 30 minutes of the family intervention with the patient present. Select it based on the service delivered and documented time, not simply because a family member attended another visit. The record should identify the patient-focused behavioral goal, participating family members, the intervention provided, the patient’s participation, and time spent. For qualifying additional intervention time, report 96168. CMS payment facts list no code-specific payment rules for this service.

Where the value comes from

  • Work RVU1.77 · 76%
  • Practice expense (office) RVU0.56 · 24%
  • Malpractice RVU0.01 · 0%

1.6K

Medicare services in 2024 · #2607 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.

96167 compared with similar codes

Office rates for Missouri, from the same CMS release.

96168

Family intervention

Each additional 15 minutes

$27.41–$28.05

96167 covers the initial 30 minutes of family intervention with the patient present; 96168 reports qualifying additional time.

96170

Hlth bhv ivntj fam wo pt 1st

No office rate

96170 is for family intervention without the patient present. Patient participation distinguishes 96167.

96158

Health behavior

Individual, initial 30 minutes

$71.32–$72.95

96158 is an individual health behavior intervention. Choose 96167 when the intervention involves the patient and family together.

96156

Health behavior assessment

Assessment or reassessment

$103.85–$106.27

96156 covers assessment or reassessment of health behavior. 96167 covers an intervention intended to address the patient’s health-related behavior or needs.

Compare 96167 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.

3 of 3 payment localities

Office and facility base rates · shared scale starting at $0

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96167 billing questions

When should I use 96167 rather than 96170?

Use 96167 when the patient participates in the family intervention. Use 96170 when the family intervention is conducted without the patient present.

What code reports additional intervention time?

Use 96168 for qualifying additional time beyond the initial 30-minute service. Document the intervention and the time that supports the additional service.

Can I report 96167 for family psychotherapy?

No. The intervention must address the patient’s health behavior or health-related needs; family psychotherapy is a different service.

How does 96167 differ from 96158?

96167 describes a patient-focused intervention involving family with the patient present. 96158 is for an individual health behavior intervention.

What should the note include?

Document the health-related goal, the patient and family members present, the intervention performed, the patient’s involvement, and the time spent.

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 96167PPRRVU2026_Oct_nonQPP.csv, line 12,771 (RVU26D)