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Part of Behavioral Health Integration

CPT 99492: Psychiatric Collaborative Care Model, initial month

First calendar month of the Psychiatric Collaborative Care Model, requiring 70 minutes of behavioral health care manager time.

Time threshold & code combinations

First 70 minutes of behavioral health care manager time in the first calendar month.

  • 99494 is the add-on for each additional 30 minutes beyond the 70-minute threshold in the same month
  • Not billed in the same month as 99484 for the same patient

Who can bill

  • Physicians and non-physician practitioners directing the behavioral health care manager

Eligibility & billing requirements

  • New or newly enrolled CoCM patient with a behavioral health condition
  • A behavioral health care manager and psychiatric consultant are engaged for the case
  • Documented consent to CoCM
  • Initial assessment, including administration of a validated rating scale
  • Development of an initial care plan with the treating practitioner
  • Entering the patient in a registry that flags the need for follow-up
  • Participation of the psychiatric consultant in the initial systematic caseload review

When to use it

New CoCM enrollment

A patient newly diagnosed with major depressive disorder is enrolled in the collaborative care program; the behavioral health care manager completes the initial assessment, rating scale, and care plan, with psychiatric consultant input.

Billing: 99492

Documentation checklist

  • Time log showing 70 minutes of behavioral health care manager time
  • Initial validated rating scale results
  • Evidence of psychiatric consultant involvement in the initial review

Common billing mistakes

  • Billing 99492 in a month after the first month of enrollment (should be 99493 instead)
  • No documented psychiatric consultant caseload review