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CPT 99493 Fee Schedule

Last Verified: July 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.

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
Key FactDetail
Service Type

Psychiatric Collaborative Care Management Services

Evaluation and 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 LevelLow
Medicare Fee ScheduleView Medicare rates for 99493

National average reimbursement for CPT 99493 by major payers:

bcbs

$149.90

uhc

$158.54

aetna

$139.88

cigna

$215.15

Preview provider-level rates for...
For billing codeCPT 99493
PayerCodeRateNPITax IDStateSpecialty
United
99493$109.971386903037 - TUNDE OMITOGUN813904483 - (TX) OMITOGUN AND ASSOCIATES PLLCTXInternal Medicine Physician (207R00000X)
United
99493$125.301063424992 - ANTONIO RAMOS204420454 - (TX) AVANTA HEALTH PROFESSIONALS P ATXInternal Medicine Physician (207R00000X)
United
99493$103.301922151588 - ROBERT DUHANEY831192518 - (TX) MAGNOLIA MEDICAL AESTHETICSTXInternal Medicine Physician (207R00000X)
United
99493$101.051033128665 - AKRAM SHAKHASHIRO203918670 - (TX) SURE CARE HEALTH ASSOCIATES PATXInternal Medicine Physician (207R00000X)
United
99493$108.941326084211 - MICHELE RAGLIN461846260 - (TX) MCCI OF TEXAS PRIMARY CARE GROUP PLLCTXInternal Medicine Physician (207R00000X)
United
99493$259.821598809741 - GRANT CRAIG752233121 - CLEBURNE FAMILY MEDICINE ASSOCIATESTXFamily Medicine Physician (207Q00000X)
United
99493$136.031851434435 - CARLOS CARRETERO741698263 - (TX) SAN ANTONIO MEDICAL ASSOCIATESTXInternal Medicine Physician (207R00000X)
United
99493$143.551922070374 - RAYMOND MUNOZ473312833 - (TX) DALLAS HOSPITAL CONSULTANTS PATXInternal Medicine Physician (207R00000X)
United
99493$179.001619297348 - ROBERTA SANDERS736045246 - (OK) NORTHEASTERN HEALTH SYSTEMTXInternal Medicine Physician (207R00000X)
United
99493$167.531609015312 - SIRISHA BHEEMANENI271371893TXInternal Medicine Physician (207R00000X)
United
99493$190.851891808291 - VINISHA PATEL300520570 - (TX) METHODIST HOSPITALTXInternal Medicine Physician (207R00000X)
United
99493$131.111639162167 - DORA GARCIA760422435 - C H WILKINSON PHYSICIAN NETWORKTXFamily Medicine Physician (207Q00000X)
United
99493$152.831649294323 - HILLCREST PHYSICIAN SERVICES, BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST742967081 - (TX) HILLCREST PHYSICIAN SERVICESTXInternal Medicine Physician (207R00000X)
United
99493$208.411679831077 - MATTHEW FREEMAN742958277 - SCOTT & WHITE CLINICTXNeurology Physician (2084N0400X)
United
99493$107.231881984235 - MAYSOON HAMED460796181 - (TX) CLEAR LAKE PRIMARY CARE PLLCTXFamily Medicine Physician (207Q00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 99493 vs. Other Evaluation and Management Codes

The CPT 99493 code is part of the Psychiatric Collaborative Care Management Services services used for Evaluation and 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 99493 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.

CodeComplexityDescription
99203-CPTLowOffice O P New Low 30 Min, Office Or Other Outpatient Visit For The Evaluation And Management Of A New Patient Which Requires A Medically Appropriate History And Or Examination And Low Level Of Medical Decision Making When Using Total Time On The Date Of The Encounter For Code Selection 30 Minutes Must Be Met Or Exceeded
99484-CPTLowCare 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
99487-CPTLowCplx Chrnc Care 1st 60 Min, 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 That 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
99493-CPTLowSbsq 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

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99493. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 99493 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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