`96156` Hlth bhv assmt/reassessment

What 96156 is

CMS fee schedule short descriptor: Hlth bhv assmt/reassessment.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 96156 (CY2026)

	Work RVU	Practice expense RVU	Malpractice RVU	Total	Medicare rate
Non-facility (office)	2.40	0.80	0.02	3.22	$107.55
Facility (hospital, ASC)	2.40	0.18	0.02	2.60	$86.84

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.

Adjust for a Medicare locality:

Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.

Medically Unlikely Edit (MUE)

Medicare caps 96156 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 96156? These codes are bundled into it

96156 is a Column 1 code in 78 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 code	Short description	Modifier indicator
`0362T`	Bhv id suprt assmt ea 15 min	0 - no modifier bypass	Check pair
`0373T`	Adapt bhv tx ea 15 min	0 - no modifier bypass	Check pair
`0403T`	Diabetes prev standard curr	1 - modifier may bypass	Check pair
`0488T`	Diabetes prev online/elec	1 - modifier may bypass	Check pair
`0591T`	Hlth&wb coaching indiv 1st	0 - no modifier bypass	Check pair
`0592T`	Hlth&wb coaching indiv f-up	0 - no modifier bypass	Check pair
`0889T`	Prsnlz trgt dvl arhfcmrigtbs	1 - modifier may bypass	Check pair
`0890T`	Arhfcmrigtbs 1st tx day	0 - no modifier bypass	Check pair
`0891T`	Arhfcmrigtbs sbsq tx day	0 - no modifier bypass	Check pair
`0892T`	Arhfcmrigtbs sbsq per tx day	0 - no modifier bypass	Check pair
`36591`	Draw blood off venous device	0 - no modifier bypass	Check pair
`36592`	Collect blood from picc	0 - no modifier bypass	Check pair
`90785`	Psytx complex interactive	0 - no modifier bypass	Check pair
`90832`	Psytx w pt 30 minutes	0 - no modifier bypass	Check pair
`90833`	Psytx w pt w e/m 30 min	0 - no modifier bypass	Check pair
`90834`	Psytx w pt 45 minutes	0 - no modifier bypass	Check pair
`90836`	Psytx w pt w e/m 45 min	0 - no modifier bypass	Check pair
`90840`	Psytx crisis ea addl 30 min	0 - no modifier bypass	Check pair
`90849`	Multiple family group psytx	0 - no modifier bypass	Check pair
`90853`	Group psychotherapy	0 - no modifier bypass	Check pair
`90863`	Pharmacologic mgmt w/psytx	0 - no modifier bypass	Check pair
`90867`	Tcranial magn stim tx plan	0 - no modifier bypass	Check pair
`90868`	Tcranial magn stim tx deli	0 - no modifier bypass	Check pair
`90869`	Tcran magn stim redetemine	0 - no modifier bypass	Check pair
`90875`	Psychophysiological therapy	0 - no modifier bypass	Check pair
`90876`	Psychophysiological therapy	0 - no modifier bypass	Check pair
`90882`	Envrn ivntj med mgmt psyc pt	0 - no modifier bypass	Check pair
`90885`	Psy evaluation of records	0 - no modifier bypass	Check pair
`90887`	Interpj/explnaj rslt psyc xm	0 - no modifier bypass	Check pair
`90889`	Preparation of report	0 - no modifier bypass	Check pair

Showing 30 of 78 column 2 codes. Use the pair checker for any specific combination.

96156 is bundled into these codes

96156 appears as a Column 2 code in 125 active edits. Reported with one of these Column 1 codes on the same date of service, 96156 is the code that denies.

Column 1 code	Short description
`0593T`	Hlth&wb coaching group	Check pair
`77427`	Radiation tx management x5	Check pair
`77431`	Radiation therapy management	Check pair
`77432`	Stereotactic radiation trmt	Check pair
`77435`	Sbrt management	Check pair
`77469`	Io radiation tx management	Check pair
`77470`	Special radiation treatment	Check pair
`90791`	Psych diagnostic evaluation	Check pair
`90792`	Psych diag eval w/med srvcs	Check pair
`90837`	Psytx w pt 60 minutes	Check pair
`90838`	Psytx w pt w e/m 60 min	Check pair
`90839`	Psytx crisis initial 60 min	Check pair
`90845`	Psychoanalysis	Check pair
`90846`	Family psytx w/o pt 50 min	Check pair
`90847`	Family psytx w/pt 50 min	Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.