$5.07
96202 covers the initial 60 minutes of multiple-family caregiver training; 96203 reports qualifying additional time.
On this page
CMS RVU26D · Effective 2026-10-01
96202 Caregiver training Medicare reimbursement rates in Wisconsin
Face-to-face behavior management training for caregivers from multiple families, reported for the initial 60 minutes when patients are not present. Compare 96202 office and facility rates across CMS payment localities in Wisconsin.
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 96202 in Wisconsin?
Wisconsin 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
$19.58
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
Facility setting
$17.03
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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.
Behavioral health
About 96202: Multiple-family caregiver behavior training
Face-to-face behavior management training for caregivers from multiple families, reported for the initial 60 minutes when patients are not present.
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.
Where the value comes from
- Work RVU0.43 · 72%
- Practice expense (office) RVU0.16 · 27%
- Malpractice RVU0.01 · 2%
661
Medicare services in 2024 · #3316 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.
96202 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
96170
No office rateHlth 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.
$11.32
96164 is a group health behavior intervention with patients participating. 96202 is caregiver training, with the patients absent.
Compare 96202 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
Wisconsin →
Office / nonfacility
$19.58
Facility
$17.03
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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 96202 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
12,775
- Code
- 96202
- Physician work
- 0.43
- Practice expense
- 0.16
- Malpractice
- 0.01
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.43 | × 1.000 | 0.4300 |
| Practice expense | 0.16 | × 0.958 | 0.1533 |
| Malpractice | 0.01 | × 0.308 | 0.0031 |
| Total RVUs | 0.5864 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wisconsin$19.58
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.43 | 1 |
| Practice expense | 0.16 | 0.958 |
| Malpractice | 0.01 | 0.308 |
(0.43 × 1 + 0.16 × 0.958 + 0.01 × 0.308) × $33.4009 = $19.58
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.43 | 1 |
| Practice expense | 0.08 | 0.958 |
| Malpractice | 0.01 | 0.308 |
(0.43 × 1 + 0.08 × 0.958 + 0.01 × 0.308) × $33.4009 = $17.03
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.
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 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.
12,77296168,,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
12,77696203,,Mlt fam grp bhv train ea add,A,,0.12,0.03,,0.02,,0.01,0.16,0.15,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,77796360,,Hydration iv infusion init,A,,0.17,0.82,,0.82,NA,0.01,1.00,1.00,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,77896361,,Hydrate iv infusion add-on,A,,0.09,0.29,,0.29,NA,0.01,0.39,0.39,5,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,