CPT 99484 Fee Schedule

Last Verified: November 2025

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Care Management Services For Behavioral Health Conditions At Least 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month Withthe Following Required Elements: Initial Assessment Or Follow-Up Monitoring Including The Use Of Applicable Validated Rating Scales; Behavioral Health Care Planning In Relation To Behavioral/Psychiatric Health Problems Including Revision For Patients Who Are (Desc Rvsd 1/1/22)

Key Fact	Detail
Service Type	• Evaluation and Management • General Behavioral Health Integration Care Management
Common Place of Service	• 11 - Office • None
Common Modifiers	• None • 25 - Significant, separately identifiable E/M service same day • GT - Via interactive audio and video telecommunication systems
Complexity Level	Moderate

National average reimbursement for CPT 99484 by major payers:

$53.95

$59.96

$48.45

$87.87

Preview provider-level rates for...

For billing codeCPT 99484

Payer	Code	Rate	NPI	Tax ID	State	Specialty
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 99484
United	99484	$82.55	1386796191 - SPENCER MILLER	752536818 - HEALTHTEXAS PROVIDER NETWORK	TX	Neurology Physician (2084N0400X)
United	99484	$62.34	1932595964 - UZAIR MUSHTAQ	741586031	TX	Internal Medicine Physician (207R00000X)
United	99484	$43.50	1396002978 - HAIXIN LI	811896357 - (TX) HOSPITAL INTERNISTS OF TEXAS	TX	Internal Medicine Physician (207R00000X)
United	99484	$43.65	1144251406 - KELLY ENGLUND	43587649 - (TX) DOROTHY COHEN SERNA MD PA	TX	Internal Medicine Physician (207R00000X)
United	99484	$64.33	1598956773 - MAHMUDA BEGUM	452498998 - (TX) ADULT INPATIENT MEDICAL SERVICES	TX	Internal Medicine Physician (207R00000X)
United	99484	$215.21	1295189330 - MATTHEW CATES	954377219	TX	Internal Medicine Physician (207R00000X)
United	99484	$68.69	1760026918 - MARIA TLETEE	263853529	TX	Internal Medicine Physician (207R00000X)
United	99484	$162.97	1972788388 - ELWALEED ELNAGAR	391678306 - AURORA MEDICAL GROUP INC	TX	Internal Medicine Physician (207R00000X)
United	99484	$26.27	1922081900 - GERALD KOPPES	900975145 - (TX) SAN ANTONIO HEART PLLC	TX	Cardiovascular Disease Physician (207RC0000X)
United	99484	$67.19	1215194873 - MRINALINI KULKARNI	300791563	TX	Internal Medicine Physician (207R00000X)
United	99484	$70.94	1972506426 - KEVIN GAFFNEY	760385980 - MHS PHYSICIANS OF TEXAS	TX	Neurology Physician (2084N0400X)
United	99484	$58.38	1639285489 - JOSEPH SCAMARDO	208536345 - (TX) PRMC HEALTHCARE GROUP INC	TX	Neurology Physician (2084N0400X)
United	99484	$38.40	1619327004 - MALIHA SHAKIL	814211994 - GENESIS MEDICAL GROUP	TX	Internal Medicine Physician (207R00000X)
United	99484	$67.19	1124480082 - KHWAJA SIDDIQUI	741613878 - (TX) BAYLOR COLLEGE OF MEDICINE	TX	Neurology Physician (2084N0400X)
United	99484	$43.50	1982950861 - QT HEALTHCARE GROUP PA	455577428 - (TX) QT HEALTHCARE GROUP PA	TX	Internal Medicine Physician (207R00000X)
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist

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CPT 99484 vs. Other General Behavioral Health Integration Care Management Codes

The CPT 99484 code is part of the Evaluation and Management services used for General Behavioral Health Integration Care Management. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 99484 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

Code	Complexity	Description
99483	Moderate	Assessment Of And Care Planning For A Patient Withcognitive Impairment Requiring An Independent Historian In The Office Or Other Outpatient Home Or Domiciliary Or Rest Home With All Of The Following Required Elements:Cognition-Focused Evaluation Including A Pertinent History And Examination Medical Decision Making Of Moderate Or High Complexity;Functional Assessment Including Decision-Making Capacity Use Of Standardized Instruments For Staging Typically 60 Mins Of Total (Desc Rvsd 1/1/23)
99484	Low	Care Management Services For Behavioral Health Conditions At Least 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month Withthe Following Required Elements: Initial Assessment Or Follow-Up Monitoring Including The Use Of Applicable Validated Rating Scales; Behavioral Health Care Planning In Relation To Behavioral/Psychiatric Health Problems Including Revision For Patients Who Are (Desc Rvsd 1/1/22)
99487	Low	Complex Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More) Chronic Conditions Expected To Last At Least 12 Months, Or Until The Death Of The Patient, Chronic Conditions Place The Patient At Significant Risk Of Death, Acute Exacerbation/Decompensation, Or Functional Decline, Comprehensive Care Plan Established, Implemented, Revised, Or Monitored, Moderate Or High Complexity Medical Decision Making;First 60 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional, Per Calendar Month.
99489	Low	Complex Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More) Chronic Conditions Expected To Last At Least 12 Months, Or Until The Death Of The Patient, Chronic Conditions Place The Patient At Significant Risk Of Death, Acute Exacerbation/Decompensation, Or Functional Decline, Comprehensive Care Plan Established, Implemented, Revised, Or Monitored, Moderate Or High Complexity Medical Decision Making; Each Additional 30 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional, Per Calendar Month (List Separately In Addition To Code For Primary Procedure)

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99484. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 99484 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules

Medicare & Medicaid Rates

Government-set reimbursement amounts

Private Insurance Rates

Negotiated rates between providers and insurance companies

Geographic Location

Costs may be higher in urban areas.

Provider Type

Hospital providers may have different rates than private practice.

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