CPT Code 96168: Health behavior intervention, family with patient, group, each additional 30 min

When to Use CPT 96168

Use CPT code 96168 when billing for health behavior intervention, family with patient, group, each additional 30 min. This code is used by licensed therapists (LCSW, LPC, MFT, Psychologist) for outpatient sessions.

Adding CPT 96168 to a Superbill

When generating a superbill with CPT 96168, 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 96168:

Documentation Requirements

Document the additional group time, topics covered, and per-patient participation in the extended session.

Common Denial Reasons

• ✗ Billed without the primary 96167 code
• ✗ Not linked to a medical condition
• ✗ Missing individual patient documentation

Modifier Notes

Add-on code — must be billed with 96167.

Reimbursement Expectations

OON reimbursement typically 35-50% of UCR. Expect $11-$30 per patient per additional 30 minutes.