CPT code 96202: Caregiver training2026 Medicare rate & RVUs in Oregon
Face-to-face behavior management training for caregivers from multiple families, reported for the initial 60 minutes when patients are not present.
Medicare pays $19.92–$20.78 for 96202 in the office in Oregon, from Rest Of Oregon to Portland. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 96202 covers
96202 covers face-to-face behavior management or behavior modification training for a group made up of caregivers from multiple families whose patients have a mental or physical health diagnosis. The patients are not present. A physician or other qualified health care professional leads the session, which may teach caregivers strategies for responding to behaviors, supporting treatment plans, or managing health-related functional challenges. The defining feature is shared training for caregivers from more than one family, rather than a group attended by patients.
Report 96202 for the initial 60 minutes of the qualifying group service. Documentation should identify the diagnosis-related training need, caregiver participants from multiple families, training goals or content, and face-to-face service time. Do not count preparation, charting, or unrelated counseling as group-training time. For additional qualifying time, report 96203. CMS assigns work, practice-expense, and malpractice relative values to this service; practice-expense values are setting-specific.
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.
Where 96202 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $20.78 | $17.81 |
| Rest Of Oregon | $19.92 | $17.26 |
How the 96202 rate is calculated
Each of 96202’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 96202
RVUs × geographic indexes × conversion factor
Work0.43
0.43 RVUs× 1.000 GPCI
Practice expense0.16
0.16 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.6000
Conversion factor
$33.4009
Medicare rate
$20.04
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 96202
96202 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 96202
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$20.04
- Non-facility (office)
- $20.04
- Facility
- $17.37
Higher because the practice carries its own overhead.
96202 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 96203Family training
- 96202 covers the initial 60 minutes of multiple-family caregiver training; 96203 reports qualifying additional time.
- 96170Hlth bhv ivntj fam wo pt 1st
- Choose 96170 for a family health behavior intervention without the patient. Choose 96202 for behavior management training with caregivers from multiple families.
- 96164Group intervention
- 96164 is a group health behavior intervention with patients participating. 96202 is caregiver training, with the patients absent.
96202 billing questions
Must the patient attend the session?
No. The service is caregiver training, and the patients are not present during the session.
How does 96202 differ from 96170?
96202 is for behavior management training with caregivers from multiple families. 96170 describes a family health behavior intervention without the patient, rather than this multiple-family training group.
Which code reports time beyond the initial 60 minutes?
Use 96203 for qualifying additional group-training time beyond the initial 60-minute service.
What should the note include?
Document the diagnosis-related training need, caregiver participation from multiple families, the training provided, and face-to-face service time.
Can 96202 be used for a group attended by patients?
No. 96202 is caregiver training without patients present; a patient-participating group health behavior intervention is represented by a different service.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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