CPT 96160 Other
Pt-focused hlth risk assmt Cost
Body System: General
Medicare Facility Rate
$3
CMS PFS CY2026
Medicare Non-Facility Rate
$3
Office/clinic setting
Hospital Outpatient
$38
OPPS rate
Frequently Asked Questions
How much does Pt-focused hlth risk assmt cost?
The Medicare facility rate is $3. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $38.
How much does Pt-focused hlth risk assmt cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $3.