Psychiatry & psychotherapy

96158 - RVUs & Medicare payment (2026)

Health behavior intervention, individual, first 30 minutes.

Component	Non-facility	Facility
Work RVU	1.66	1.66
Practice expense RVU	0.54	0.12
Malpractice RVU	0.01	0.01
Total RVUs	2.21	1.79
National payment (CF $33.4009)	$73.82	$59.79
Qualifying APM payment (CF $33.5675)	$74.18	$60.09

How 96158 payment varies by locality

Medicare adjusts payment with geographic practice cost indices, so the same code pays differently across the 109 fee schedule localities. In 2026, non-facility payment for 96158 ranges from $71.11 in Arkansas (AR) to $102.56 in Alaska (AK); calculate 96158 for your locality.

Alaska (AK) $102.56 San Jose-Sunnyvale-Santa Clara (CA) $87.73 San Jose-Sunnyvale-Santa Clara (CA) $87.69 San Francisco-Oakland-Berkeley (CA) $86.30 San Francisco-Oakland-Berkeley (CA) $86.29 Napa (CA) $82.88 Vallejo (CA) $82.86 NYC Suburbs/Long Island (NY) $81.06 National average $73.82 … 97 more localities between … Alabama (AL) $71.42 Rest Of Missouri (MO) $71.32 Mississippi (MS) $71.22 Arkansas (AR) $71.11

Non-facility payment for 96158 in the 2026 fee schedule ($33.4009 conversion factor), before sequestration. Gray bar = national average.

Global period: XXX

No global period: the global surgery concept does not apply to this code.

Related codes - psychiatry & psychotherapy

90791 · psychiatric diagnostic evaluation, no medical services
90792 · psychiatric diagnostic evaluation with medical services
90832 · psychotherapy, 30 minutes
90833 · psychotherapy 30 minutes, add-on to an e/m visit
90834 · psychotherapy, 45 minutes
90836 · psychotherapy 45 minutes, add-on to an e/m visit
90837 · psychotherapy, 60 minutes
90838 · psychotherapy 60 minutes, add-on to an e/m visit
90839 · psychotherapy for crisis, first 60 minutes
90846 · family psychotherapy without the patient present, 50 minutes
90847 · family psychotherapy with the patient present, 50 minutes
90853 · group psychotherapy
96130 · psychological test evaluation, first hour
96131 · psychological test evaluation, each additional hour
96136 · psychological/neuropsychological test administration, first 30 minutes
96156 · health behavior assessment or re-assessment

Frequently asked questions

How much does Medicare pay for 96158 in 2026?

The national non-facility payment is $73.82 and the facility payment is $59.79, using the standard $33.4009 conversion factor. Actual amounts vary by Medicare locality; use the RVU calculator for your area.

What is the work RVU for 96158?

The 2026 work RVU for 96158 is 1.66. Total RVUs are 2.21 in the non-facility setting and 1.79 in the facility setting.

Why are the facility and non-facility amounts different?

Only the practice expense component changes by setting. In an office (non-facility) the practice bears the overhead, so the PE RVU is higher; in a hospital or ASC the facility bills its own overhead separately.

Source: CMS Physician Fee Schedule relative value file (rvu26c.zip, retrieved 2026-07-11). Service description is an original plain-English summary, not CPT descriptor text. CPT® is a registered trademark of the American Medical Association. Amounts are estimates before sequestration and claim-level adjustments.