CPT Code 96170: Health behavior intervention, family without patient, group, first 30 min

When to Use CPT 96170

Use CPT code 96170 when billing for health behavior intervention, family without patient, group, first 30 min. This code is used by licensed therapists (LCSW, LPC, MFT, Psychologist) for outpatient sessions.

Adding CPT 96170 to a Superbill

When generating a superbill with CPT 96170, 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 96170:

Documentation Requirements

Document patient absence rationale, which family members attended, group size, and how the session supports behavioral management of the patient medical condition.

Common Denial Reasons

• ✗ Patient was present for one or more families — should use 96167
• ✗ Not linked to a medical diagnosis
• ✗ Missing documentation of patient absence rationale

Reimbursement Expectations

OON reimbursement typically 35-55% of UCR. Expect $14-$44 per patient.