96161
Caregiver health risk assmt
Administration of a caregiver-focused health risk assessment instrument, with scoring and documentation, per standardized tool. The caregiver-completed HRA, distinct from 96160 (patient-focused), used when the caregiver of a pediatric, geriatric, or dependent adult patient completes the assessment on the patient's behalf.
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 96161 is locked
- When to use it: the exact clinical situations that support billing 96161
- Documentation checklist: the 5 elements your note needs before submitting
- Common pitfalls: the 5 mistakes that get 96161 downcoded or denied
Payer notes
Medicare and commercial payers cover 96161 when caregiver HRA is appropriately administered and documented. Pediatric well-care visits with caregiver-completed maternal depression screening (Edinburgh) are a common use case. Geriatric ambulatory practice uses 96161 in cognitive impairment workups. Coverage is broad; payer audits focus on documentation of the caregiver as respondent and the action plan.
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 96161 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.