CPT Code 96160: Administration of Patient-Focused Health Risk Assessment Instrument

CPT code 96160 refers to the administration of a patient-focused health risk assessment instrument, such as a health hazard appraisal, with scoring and documentation, per standardized instrument. This code is used when a healthcare provider administers a validated, scorable questionnaire to identify specific health risks that may impact a patient's physical health and documents the results in the patient's medical record.

CPT code 96160 can be billed as a standalone service only if it is not considered part of another service being provided during the same visit, such as a Medicare Annual Wellness Visit or preventive service. If the health risk assessment is already included in another billed service (e.g., a well visit), 96160 should not be billed separately.

The primary difference between CPT codes 96127 and 96160 lies in the focus of the assessment: 96127 is used for brief emotional or behavioral assessments targeting mental health conditions (such as depression inventories or ADHD scales), while 96160 is used for patient-focused health risk assessments that evaluate how various factors (including mental health) may affect a patient's physical health.