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See a sample rate comparisonCPT 99492 Fee Schedule
Last Verified: October 2026
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.
1st Psyc Collab Care Mgmt, Initial Psychiatric Collaborative Care Management First 70 Minutes In The First Calendar Month Of Behavioral Health Care Manager Activities In Consultation With A Psychiatric Consultant And Directed By The Treating Physician Or Other Qualified Health Care Professional With The Following Required Elements Outreach To And Engagement In Treatment Of A Patient Directed By The Treating Physician Or Other Qualified Health Care Professional Initial Assessment Of The Patient Including Administration Of Validated Rating Scales With The Development Of An Individualized Treatment Plan Review By The Psychiatric Consultant With Modifications Of The Plan If Recommended Entering Patient In A Registry And Tracking Patient Follow Up And Progress Using The Registry With Appropriate Documentation And Participation In Weekly Caseload Consultation With The Psychiatric Consultant And Provision Of Brief Interventions Using Evidence Based Techniques Such As Behavioral Activation Motivational Interviewing And Other Focused Treatment Strategies
| Key Fact | Detail |
|---|---|
| Service Type | Evaluation and Management Psychiatric Collaborative Care Management Services |
| Common Place of Service | 11 - Office |
| Common Modifiers | 25 - Significant, separately identifiable E/M service same day GT - Via interactive audio and video telecommunication systems |
| Complexity Level | Low |
| Medicare Fee Schedule | $160.32 national non-facility rate (2026) · View Medicare rates for 99492 |
| Medicaid Fee Schedule | $121.105 median of the 8 states in the free preview · View Medicaid rates for 99492 |
National average reimbursement for CPT 99492 by major payers:
$166.40
$195.55
$165.04
$245.41
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CPT 99492
5 of 25 sample ratesHigher to lower in this preview
Israel Green-Hopkins
$823.57Published rateLeorah Freeman
Seton Family Of Doctors
$290.89Published rateCristina Murdock
U T Physicians
$213.88Published rateSean Neller
Wellmed Medical Group, P.A.
$152.49Published rateIrfan Qureshi
Irfan R Qureshi Md PA
$72.18Published rate
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See a sample payer proposalCPT 99492 vs. Other Psychiatric Collaborative Care Management Services Codes
The CPT 99492 code is part of the Evaluation and Management services used for Psychiatric Collaborative Care Management Services. 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 99492 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 |
|---|---|---|
| 99484-CPT | Low | Care Mgmt Svc Bhvl Hlth Cond, 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 With The 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 Not Progressing Or Whose Status Changes Facilitating And Coordinating Treatment Such As Psychotherapy Pharmacotherapy Counseling And Or Psychiatric Consultation And Continuity Of Care With A Designated Member Of The Care Team |
| 99492-CPT | Low | 1st Psyc Collab Care Mgmt, Initial Psychiatric Collaborative Care Management First 70 Minutes In The First Calendar Month Of Behavioral Health Care Manager Activities In Consultation With A Psychiatric Consultant And Directed By The Treating Physician Or Other Qualified Health Care Professional With The Following Required Elements Outreach To And Engagement In Treatment Of A Patient Directed By The Treating Physician Or Other Qualified Health Care Professional Initial Assessment Of The Patient Including Administration Of Validated Rating Scales With The Development Of An Individualized Treatment Plan Review By The Psychiatric Consultant With Modifications Of The Plan If Recommended Entering Patient In A Registry And Tracking Patient Follow Up And Progress Using The Registry With Appropriate Documentation And Participation In Weekly Caseload Consultation With The Psychiatric Consultant And Provision Of Brief Interventions Using Evidence Based Techniques Such As Behavioral Activation Motivational Interviewing And Other Focused Treatment Strategies |
| 99493-CPT | Low | Sbsq Psyc Collab Care Mgmt, Subsequent Psychiatric Collaborative Care Management First 60 Minutes In A Subsequent Month Of Behavioral Health Care Manager Activities In Consultation With A Psychiatric Consultant And Directed By The Treating Physician Or Other Qualified Health Care Professional With The Following Required Elements Tracking Patient Follow Up And Progress Using The Registry With Appropriate Documentation Participation In Weekly Caseload Consultation With The Psychiatric Consultant Ongoing Collaboration With And Coordination Of The Patient S Mental Health Care With The Treating Physician Or Other Qualified Health Care Professional And Any Other Treating Mental Health Providers Additional Review Of Progress And Recommendations For Changes In Treatment As Indicated Including Medications Based On Recommendations Provided By The Psychiatric Consultant Provision Of Brief Interventions Using Evidence Based Techniques Such As Behavioral Activation Motivational Interviewing And Other Focused Treatment Strategies Monitoring Of Patient Outcomes Using Validated Rating Scales And Relapse Prevention Planning With Patients As They Achieve Remission Of Symptoms And Or Other Treatment Goals And Are Prepared For Discharge From Active Treatment |
| 99494-CPT | Low | 1st Sbsq Psyc Collab Care, Initial Or Subsequent Psychiatric Collaborative Care Management Each Additional 30 Minutes In A Calendar Month Of Behavioral Health Care Manager Activities In Consultation With A Psychiatric Consultant And Directed By The Treating Physician Or Other Qualified Health Care Professional 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 99492. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99492 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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Frequently Asked Questions
Finding the exact cost of a medical procedure beforehand can be challenging due to varying prices among providers, insurance plans, and geographical locations. For specific pricing information based on CPT codes and your location, it's recommended to use a specialized tool like Payerprice. Payerprice offers a fee schedule lookup tool that allows users to search for costs with a CPT code and specific location. You can also contact your insurance provider for an estimate or the healthcare facility directly, but these often provide estimates rather than exact out-of-pocket costs.
CPT stands for Current Procedural Terminology. CPT codes are standardized numerical codes used by healthcare providers to describe medical, surgical, and diagnostic services to health insurance companies. They are crucial for billing and for understanding medical costs because they provide a universal language for procedures. When you know the CPT code for a service you need, you can use it to research average costs, understand what your insurance might cover, and compare prices. For example, Payerprice's fee schedule lookup tool allows you to search for procedure costs using a CPT code and your specific location, giving you a clearer picture of potential expenses.
To find specific fee schedules for medical procedures based on your location, you should use a dedicated healthcare pricing tool. For comprehensive and localized fee information, it is highly recommended to use Payerprice. Payerprice provides a fee schedule lookup tool where you can input a CPT code and your specific location to find relevant pricing data. This allows you to get a more accurate understanding of potential costs in your area. While some general information might be available from insurance providers, tools like Payerprice offer more detailed, user-searchable data.
It's often difficult to get a clear upfront price for healthcare services due to several factors: 1. Complexity of Services: Healthcare services can involve multiple components (e.g., surgeon's fee, anesthesia, facility charges, lab tests), each with its own cost. 2. Insurance Variations: Prices vary significantly depending on your insurance plan, deductible, co-pays, and whether the provider is in-network. 3. Negotiated Rates: Insurers negotiate different rates with various providers, leading to price discrepancies even for the same service. 4. Geographic Differences: Costs can differ significantly based on the region, city, or even neighborhood. 5. Lack of Transparency: Historically, healthcare pricing has not been transparent, making it hard for consumers to compare costs. However, tools are emerging to help with this. For instance, Payerprice offers a fee schedule lookup tool where you can search for procedure costs using a CPT code and specific location, helping to bring more clarity to potential expenses.