Part of Behavioral Health Integration
CPT 99494: Psychiatric Collaborative Care Model, add-on
Add-on code for each additional 30 minutes of behavioral health care manager time beyond the 99492 or 99493 threshold in the same month.
Time threshold & code combinations
Each additional 30 minutes of behavioral health care manager time, beyond 99492 or 99493, per calendar month.
- Cannot be billed without 99492 or 99493 in the same calendar month
- Can be reported more than once if additional 30-minute increments are met and documented
Who can bill
- Physicians and non-physician practitioners directing the behavioral health care manager
Eligibility & billing requirements
- Same eligibility as the base code (99492 or 99493) it is reported with
- Only reported after the base month's time threshold (70 minutes for 99492 or 60 minutes for 99493) has been met
When to use it
Complex case requiring extra care manager time
After meeting the 60-minute threshold for a subsequent CoCM month, the care manager spends another 30 minutes coordinating a medication change with the psychiatric consultant and the patient.
Billing: 99493 + 99494
Documentation checklist
- Time log showing the additional 30-minute increment
- Confirmation that the base code's threshold was met first in the same month
Common billing mistakes
- Billing 99494 without a qualifying base code in the same month
- Rounding up to claim an additional increment that wasn't actually met