# CPT 96159: Health Behavior Ivntj Indiv F2f Ea Addl 15 Min

Medicare CPT 96159 pays $25.38 in a non-facility setting and $20.37 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $24.49 in Arkansas to $35.32 in Alaska, a 44% spread.

Web page: https://www.med-reveal.com/rates/96159-cpt-fee-schedule
Section: Medical and Therapeutic Services
Billed by: Child & Adolescent Psychiatry, Clinical Neuropsychologist, Counselor, Psychiatry & Neurology

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $25.38 |
| National facility | $20.37 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $35.32 | $29.98 |
| District of Columbia | $27.54 | $21.64 |
| California | $27.23 | $21.30 |
| New Jersey | $27.17 | $21.53 |
| New York | $27.02 | $21.43 |
| Washington | $26.88 | $21.16 |
| Massachusetts | $26.72 | $21.08 |
| Connecticut | $26.25 | $20.86 |
| Hawaii | $26.25 | $20.56 |
| Colorado | $26.02 | $20.69 |
| Rhode Island | $25.96 | $20.78 |
| Maryland | $25.90 | $20.68 |
| Oregon | $25.88 | $20.60 |
| New Hampshire | $25.64 | $20.43 |
| Minnesota | $25.57 | $20.41 |
| Puerto Rico | $25.45 | $20.39 |
| Virgin Islands | $25.45 | $20.39 |
| Pennsylvania | $25.42 | $20.52 |
| Florida | $25.41 | $20.38 |
| Delaware | $25.40 | $20.45 |
| Nevada | $25.39 | $20.38 |
| Texas | $25.39 | $20.46 |
| Montana | $25.38 | $20.37 |
| North Dakota | $25.38 | $20.37 |
| South Dakota | $25.38 | $20.37 |
| Wyoming | $25.38 | $20.37 |
| Vermont | $25.32 | $20.36 |
| Virginia | $25.28 | $20.35 |
| Illinois | $25.24 | $20.40 |
| Arizona | $25.19 | $20.33 |
| Georgia | $25.12 | $20.34 |
| Wisconsin | $25.12 | $20.32 |
| Maine | $25.10 | $20.31 |
| Utah | $25.00 | $20.29 |
| Michigan | $24.99 | $20.30 |
| North Carolina | $24.96 | $20.29 |
| Indiana | $24.92 | $20.28 |
| Nebraska | $24.90 | $20.27 |
| South Carolina | $24.90 | $20.27 |
| Idaho | $24.88 | $20.27 |
| Missouri | $24.86 | $20.26 |
| New Mexico | $24.86 | $20.26 |
| Iowa | $24.85 | $20.26 |
| Louisiana | $24.83 | $20.26 |
| Ohio | $24.83 | $20.26 |
| Tennessee | $24.81 | $20.25 |
| Kansas | $24.78 | $20.25 |
| Oklahoma | $24.71 | $20.23 |
| Kentucky | $24.68 | $20.23 |
| Alabama | $24.59 | $20.21 |
| West Virginia | $24.55 | $20.20 |
| Mississippi | $24.50 | $20.19 |
| Arkansas | $24.49 | $20.19 |

## Related codes

- 90632: Hepa Vaccine Adult Dose for Intramuscular Use — https://www.med-reveal.com/rates/90632-cpt-fee-schedule
- 90633: Hepa Vaccine 2 Dose Schedule Ped/adolesc Im Use — https://www.med-reveal.com/rates/90633-cpt-fee-schedule
- 90647: Hib Prp-omp Vaccine 3 Dose Schedule Im Use — https://www.med-reveal.com/rates/90647-cpt-fee-schedule
- 90648: Hib Prp-t Vaccine 4 Dose Schedule Im Use — https://www.med-reveal.com/rates/90648-cpt-fee-schedule
- 90680: Rv5 Vaccine 3 Dose Schedule Live for Oral Use — https://www.med-reveal.com/rates/90680-cpt-fee-schedule
- 90681: Rv1 Vaccine 2 Dose Schedule Live for Oral Use — https://www.med-reveal.com/rates/90681-cpt-fee-schedule
- 90698: Dtap-ipv/hib Vaccine for Intramuscular Use — https://www.med-reveal.com/rates/90698-cpt-fee-schedule
- 90710: Measles Mumps Rubella Varicella Vacc Live Subq — https://www.med-reveal.com/rates/90710-cpt-fee-schedule

Commercial negotiated rates for 96159 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules