CPT Code 96158: Health behavior intervention, individual, each additional 30 min

When to Use CPT 96158

Use CPT code 96158 when billing for health behavior intervention, individual, each additional 30 min. This code is used by licensed therapists (LCSW, LPC, MFT, Psychologist) for outpatient sessions.

Adding CPT 96158 to a Superbill

When generating a superbill with CPT 96158, include the ICD-10 diagnosis code, date of service, fee charged, amount paid, and your NPI number. Superbilled pre-fills common therapy CPT codes automatically.

Common ICD-10 Pairings

These diagnosis codes are frequently used alongside CPT 96158:

Documentation Requirements

Document the additional intervention time and specific techniques used in the extended session. Justify clinical need for continued intervention.

Common Denial Reasons

• ✗ Billed without a primary health behavior intervention code
• ✗ Not linked to a medical condition
• ✗ Intervention time exceeds clinical justification

Modifier Notes

Add-on code — must be billed with the primary individual intervention code.

Reimbursement Expectations

OON reimbursement typically 45-60% of UCR. Expect $27-$72 per additional 30 minutes.