Part of Behavioral Health Integration
CPT 99493: Psychiatric Collaborative Care Model, subsequent months
Subsequent calendar months of the Psychiatric Collaborative Care Model, requiring 60 minutes of behavioral health care manager time.
Time threshold & code combinations
First 60 minutes of behavioral health care manager time in a subsequent calendar month.
- 99494 is the add-on for each additional 30 minutes beyond the 60-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
- Patient already enrolled in CoCM from a prior month
- Ongoing engagement of the behavioral health care manager and psychiatric consultant
- Tracking of validated rating scale results over time
- Weekly (or otherwise regular) systematic caseload review with the psychiatric consultant
- Care plan revisions based on measurement-based care and treatment response
When to use it
Ongoing collaborative care monitoring
In month three of CoCM, the behavioral health care manager tracks the patient's rating scale trend, reviews the case with the psychiatric consultant, and updates the treatment plan based on partial response.
Billing: 99493
Documentation checklist
- Time log showing 60 minutes of behavioral health care manager time
- Updated rating scale results
- Evidence of the ongoing psychiatric consultant caseload review
Common billing mistakes
- Billing 99493 for a patient's first month of CoCM enrollment (should be 99492 instead)
- Gaps in rating-scale tracking that make measurement-based care hard to demonstrate