# CPT 96160: Pt-focused Hlth Risk Assmt Score Doc Stnd Instrm

Medicare CPT 96160 pays $3.01 in a non-facility setting and $3.01 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $2.58 in Arkansas to $3.55 in California, a 38% spread.

Web page: https://www.med-reveal.com/rates/96160-cpt-fee-schedule
Section: Medical and Therapeutic Services
Billed by: Child & Adolescent Psychiatry, Clinical Neuropsychologist, Family Medicine, Marriage & Family Therapist, Pediatrics, Social Worker

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $3.01 |
| National facility | $3.01 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| California | $3.55 | $3.55 |
| District of Columbia | $3.54 | $3.54 |
| Washington | $3.43 | $3.43 |
| Hawaii | $3.42 | $3.42 |
| New Jersey | $3.39 | $3.39 |
| Massachusetts | $3.38 | $3.38 |
| New York | $3.35 | $3.35 |
| Connecticut | $3.24 | $3.24 |
| Alaska | $3.20 | $3.20 |
| Colorado | $3.20 | $3.20 |
| Oregon | $3.17 | $3.17 |
| Maryland | $3.14 | $3.14 |
| New Hampshire | $3.13 | $3.13 |
| Rhode Island | $3.11 | $3.11 |
| Minnesota | $3.09 | $3.09 |
| Puerto Rico | $3.04 | $3.04 |
| Virgin Islands | $3.04 | $3.04 |
| Florida | $3.02 | $3.02 |
| Montana | $3.01 | $3.01 |
| Nevada | $3.01 | $3.01 |
| North Dakota | $3.01 | $3.01 |
| South Dakota | $3.01 | $3.01 |
| Wyoming | $3.01 | $3.01 |
| Vermont | $2.98 | $2.98 |
| Delaware | $2.97 | $2.97 |
| Texas | $2.96 | $2.96 |
| Pennsylvania | $2.95 | $2.95 |
| Virginia | $2.95 | $2.95 |
| Arizona | $2.91 | $2.91 |
| Illinois | $2.91 | $2.91 |
| Maine | $2.88 | $2.88 |
| Wisconsin | $2.88 | $2.88 |
| Georgia | $2.87 | $2.87 |
| Utah | $2.83 | $2.83 |
| Michigan | $2.82 | $2.82 |
| North Carolina | $2.80 | $2.80 |
| Indiana | $2.79 | $2.79 |
| South Carolina | $2.78 | $2.78 |
| Idaho | $2.77 | $2.77 |
| Nebraska | $2.77 | $2.77 |
| Missouri | $2.76 | $2.76 |
| New Mexico | $2.76 | $2.76 |
| Iowa | $2.75 | $2.75 |
| Louisiana | $2.75 | $2.75 |
| Ohio | $2.74 | $2.74 |
| Tennessee | $2.73 | $2.73 |
| Kansas | $2.72 | $2.72 |
| Oklahoma | $2.68 | $2.68 |
| Kentucky | $2.67 | $2.67 |
| Alabama | $2.63 | $2.63 |
| West Virginia | $2.61 | $2.61 |
| Mississippi | $2.59 | $2.59 |
| Arkansas | $2.58 | $2.58 |

## 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 96160 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