96160
Pt-focused hlth risk assmt
Administration of a patient-focused health risk assessment instrument, with scoring and documentation, per standardized tool. The patient-completed HRA used at preventive visits, AWVs, and chronic disease management encounters.
Published by RVUDoc. Numeric data: CMS RVU26C, effective 2026-07-01. Page updated 2026-09-23. Calculation limits and editorial policy.
Fee-schedule estimate before claim adjustments. Coverage, setting and payer rules still apply.
Billing guidance for 96160 is locked
- When to use it: the exact clinical situations that support billing 96160
- Documentation checklist: the 5 elements your note needs before submitting
- Common pitfalls: the 5 mistakes that get 96160 downcoded or denied
Payer notes
Medicare covers 96160 when administered at appropriate preventive visits. Medicare Advantage plans typically follow Medicare. Commercial payers vary; many cover 96160 as part of routine adult preventive care. Documentation of the standardized tool name and score is critical for audit defense.
Related codes
These include alternative services and possible add-ons. Listing codes together does not establish that they can be billed together; check the applicable edits and payer policy.
See what 96160 adds to your year
Add it to the wRVU calculator with your own volume, or paste a note and let the chart audit check your coding.