Screening / Counsel · CMS status A
96160
Pt-focused hlth risk assmt
Administration of a patient-focused health risk assessment instrument, with scoring and documentation, per standardized tool. CMS 2026 wRVU 0.05. The patient-completed HRA used at preventive visits, AWVs, and chronic disease management encounters.
Work RVU
0.00
2026 Medicare pays
$3.01
National GPCI · non-facility · CF $33.4009
RVU anatomyWork 0.00 + Practice 0.09 + Malpractice 0.00 = 0.09 total
Work (your effort)Practice expenseMalpractice
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
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Common ICD-10 pairings
Z00.00Z13.89
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.
Pairs well with
Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.