CPT 96156 Other

How Much Does Hlth bhv assmt/reassessment Cost?

Hlth bhv assmt/reassessment (CPT 96156) costs $87 at Medicare rates. Hospital outpatient rate: $104.

Cost Comparison by Payer

How much Hlth bhv assmt/reassessment costs across different settings and payers

Medicare
Facility rate
$87
Hospital Outpatient
OPPS rate
$104
Medicare (Facility)
$87
CMS PFS 2026 national rate
Medicare (Office/Clinic)
$108
Non-facility setting
Hospital Outpatient
$104
OPPS rate

Procedures Commonly Done Together

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How to Reduce Your Cost for Hlth bhv assmt/reassessment

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    For this procedure, the office rate ($108) differs from the facility rate ($87). Ask if it can be done in an office setting.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

2.40
Work RVU
0.18
Practice Expense RVU
0.02
Malpractice RVU
3.22
Total RVU

Payment = Total RVU (3.22) x CF ($33.40) = $108

Frequently Asked Questions

How much does Hlth bhv assmt/reassessment cost?

The Medicare facility rate for Hlth bhv assmt/reassessment is $87. In a hospital outpatient setting, the rate is $104. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Hlth bhv assmt/reassessment cost without insurance?

Without insurance, the cost of Hlth bhv assmt/reassessment can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Hlth bhv assmt/reassessment?

Most commercial health insurance plans and Medicare cover Hlth bhv assmt/reassessment when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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