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Individual Behavior Change Counseling, First 30 Min

Pennsylvania rates for HCPCS 96158

This is a one-on-one counseling session with a trained clinician, such as a psychologist, focused on helping someone change habits that affect an existing physical health condition, such as improving diet, exercise, or medication routines for a condition like diabetes or heart disease. It covers the first 30 minutes of the session. It is aimed at supporting treatment of a diagnosed physical illness rather than treating a mental health condition on its own.

Facilitymedian $89 · 10th–90th $60$950%50%10th90th$89Professionalmedian $65 · 10th–90th $52$1350%20%10th90th$65$10.0$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$95.50
Aetna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$64.57
Typical High
$134.90
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$72.44
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$74.13
Typical High
$114.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$70.79
Typical High
$117.49
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$44.67
Typical High
$109.65
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$64.57
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$74.13
Typical High
$138.04
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$61.66
Typical High
$97.72
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$67.61
Typical High
$131.83
Optum
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$58.88
Typical High
$75.86
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$57.54
Typical High
$75.86
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$22.39
Median
$56.23
Typical High
$104.71
United
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$66.07
Typical High
$114.82