CPT 96164 reports a group health behavior intervention for two or more patients, focused on a physical health problem, for the initial 30 minutes.
When to use 96164
Use 96164 to deliver a group-format behavioral intervention tied to a medical condition. The individual equivalent is 96158 and the family equivalent is 96167.
How to bill it
Report for the first 30 minutes and add 96165 for each additional 15 minutes of group intervention.
Common pitfalls
- Confusing group (96164) with individual (96158) intervention.
- Forgetting the 96165 add-on for additional time.
Frequently asked questions
When do I add 96165?
Add 96165 for each additional 15 minutes of group health behavior intervention beyond the initial 30 minutes.
Can 96164 be used for a mental health group?
No. It is tied to a physical health problem; behavioral health therapy groups use other codes such as 90853.