CPT 96156 Fee Schedule

Last Verified: November 2025

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Physician Supervision Of A Patient Under A Medicare-Approved Hospice (Patient Not Present) Requiring Complex And Multidisciplinary Care Modalities Involving Regular Physician Development And/Or Revision Of Care Plans, Review Of Subsequent Reports Of Patient Status, Review Of Laboratory And Other Studies, Communication (Including Telephone Calls) With Other Health Care Professionals Involved In The Patient's Care, Integration Of New Information Into The Medical Treatment Plan And/Or Adjustment Of

Key Fact	Detail
Service Type	• Medicine Services and Procedures • Health Behavior Assessment and Intervention Procedures
Common Place of Service	• 11 - Office • None
Common Modifiers	• None • 59 - Distinct Procedural Service • GT - Via interactive audio and video telecommunication systems
Complexity Level	Low

National average reimbursement for CPT 96156 by major payers:

$121.47

$94.33

$124.09

$159.25

Preview provider-level rates for...

For billing codeCPT 96156

Payer	Code	Rate	NPI	Tax ID	State	Specialty
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 96156
United	96156	$71.41	1952521791 - PHILIP WOERNER	237244801 - (IL) CASS COUNTY MENTAL HEALTH ASSOCIATION	IL	Psychiatry Physician (2084P0800X)
United	96156	$99.98	1558354357 - MARIA FISFALEN	363305449 - (IL) MOUNT SINAI COMMUNITY FOUNDATION	IL	Psychiatry Physician (2084P0800X)
United	96156	$84.98	1558314583 - NANCY PECEN	824934016 - (IL) NANCEY E PECEN MD SC	IL	Psychiatry Physician (2084P0800X)
United	96156	$163.50	1225211600 - JOHN MILLICHAP	362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION	CO	Neurology with Special Qualifications in Child Neurology Physician (2084N0402X)
United	96156	$92.19	1891180154 - DARA WILCZYNSKI	362739299 - TRINITY MEDICAL CENTER	IL	Psychiatry Physician (2084P0800X)
United	96156	$71.41	1275564197 - PAUL BERKOWITZ	272583676 - ROCKFORD PSYCHIATRIC SERVICES, SC	AZ	Psychiatry Physician (2084P0800X)
United	96156	$108.91	1063972404 - MAANASA BANDLA	811324691	MA	Child & Adolescent Psychiatry Physician (2084P0804X)
United	96156	$167.74	1477670461 - LOUIS KRAUS	911780160	IL	Child & Adolescent Psychiatry Physician (2084P0804X)
United	96156	$84.98	1417621541 - SARAH TISSER	364076717	IL	Psychiatry Physician (2084P0800X)
United	96156	$80.94	1093005639 - STEVEN MEEK	237098532 - SARAH BUSH LINCOLN HEALTH CENTER	MN	Psychiatry Physician (2084P0800X)
United	96156	$80.94	1306848817 - MARK FREEMAN	371339926 - (IL) ILLINOIS ASSOCIATES IN PSYCHIA	IL	Psychiatry Physician (2084P0800X)
United	96156	$99.98	1124084967 - SANDEEP GAONKAR	843229208 - (IL) GATEWAY PROFESSIONAL SERVICES PC	IL	Psychiatry Physician (2084P0800X)
United	96156	$115.83	1831243831 - PAMELA VERGARA-RODRIGUEZ	366006541 - (IL) VETERANS ASSISTANCE COMMISSION C	IL	Psychiatry Physician (2084P0800X)
United	96156	$95.22	1730263617 - MARK ALTER	331075317 - NCHMD INC	WI	Child & Adolescent Psychiatry Physician (2084P0804X)
United	96156	$99.98	1285083931 - MARIYAH HUSSAIN	363917885 - (IL) HAMDARD HEALTH ALLIANCE	IL	Child & Adolescent Psychiatry Physician (2084P0804X)
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist

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CPT 96156 vs. Other Health Behavior Assessment and Intervention Procedures Codes

The CPT 96156 code is part of the Medicine Services and Procedures services used for Health Behavior Assessment and Intervention Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 96156 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

Code	Complexity	Description
96156-CPT	Low	Physician Supervision Of A Patient Under A Medicare-Approved Hospice (Patient Not Present) Requiring Complex And Multidisciplinary Care Modalities Involving Regular Physician Development And/Or Revision Of Care Plans, Review Of Subsequent Reports Of Patient Status, Review Of Laboratory And Other Studies, Communication (Including Telephone Calls) With Other Health Care Professionals Involved In The Patient's Care, Integration Of New Information Into The Medical Treatment Plan And/Or Adjustment Of
96158-CPT	Low	Level 1 Hospital Emergency Department Visit Provided In A Type B Emergency Department; (The Ed Must Meet At Least One Of The Following Requirements: (1) It Is Licensed By The State In Which It Is Located Under Applicable State Law As An Emergency Room Or Emergency Department; (2) It Is Held Out To The Public (By Name, Posted Signs, Advertising, Or Other Means) As A Place That Provides Care For Emergency Medical Conditions On An Urgent Basis Without Requiring A Previously Scheduled Appointment; O
96159-CPT	Low	Level 2 Hospital Emergency Department Visit Provided In A Type B Emergency Department; (The Ed Must Meet At Least One Of The Following Requirements: (1) It Is Licensed By The State In Which It Is Located Under Applicable State Law As An Emergency Room Or Emergency Department; (2) It Is Held Out To The Public (By Name, Posted Signs, Advertising, Or Other Means) As A Place That Provides Care For Emergency Medical Conditions On An Urgent Basis Without Requiring A Previously Scheduled Appointment; O
96160-CPT	Low	Administration Of Patient-Focused Health Risk Assessment Instrument (Eg Health Hazard Apprai- Sal) With Scoring And Documentation Per Standar- Dized Instrument

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 96156. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 96156 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules

Medicare & Medicaid Rates

Government-set reimbursement amounts

Private Insurance Rates

Negotiated rates between providers and insurance companies

Geographic Location

Costs may be higher in urban areas.

Provider Type

Hospital providers may have different rates than private practice.

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