CPT 99493 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Evaluation and Management • Psychiatric Collaborative Care Management Services |
| 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 | Low |
National average reimbursement for CPT 99493 by major payers:
$149.90
$158.54
$139.88
$222.46
| 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 99493 | ||||||
United | 99493 | $138.94 | 1497702708 - DAVID TYSON | 752239700 - (TX) AMARILLO FAMILY PHYSICIANS CLINIC | TX | Family Medicine Physician (207Q00000X) |
United | 99493 | $101.05 | 1548244668 - TOMMY YEE | 742123618 - TOMMY YEE, M.D., P.A. | TX | Neurology Physician (2084N0400X) |
United | 99493 | $69.01 | 1598298077 - JOHN TOHLEN | 201434993 - (TX) DIXDOWELL ASSOCIATES | TX | Family Medicine Physician (207Q00000X) |
United | 99493 | $167.53 | 1982654554 - LALITHA JAGADISH | 271371893 | TX | Internal Medicine Physician (207R00000X) |
United | 99493 | $147.41 | 1578594651 - UMA CHINTAPALLI | 364618117 - (TX) SREE MEDICALS PLLC | TX | Internal Medicine Physician (207R00000X) |
United | 99493 | $160.30 | 1356877369 - HUNG HOANG | 752896138 - MEDHEALTH | TX | Internal Medicine Physician (207R00000X) |
United | 99493 | $292.04 | 1700175171 - SHANE MAGEE | 760386391 - KELSEY-SEYBOLD MEDICAL GROUP PLLC | TX | Internal Medicine Physician (207R00000X) |
United | 99493 | $147.41 | 1487762365 - BOB FELTY | 412135442 - MIDLOTHIAN FAMILY MEDICINE CLINIC | TX | Family Medicine Physician (207Q00000X) |
United | 99493 | $167.53 | 1609015312 - SIRISHA BHEEMANENI | 271371893 | TX | Internal Medicine Physician (207R00000X) |
United | 99493 | $166.72 | 1487218798 - DAVID CAVANESS | 752616977 - CHRISTUS TRINITY CLINIC | TX | Sports Medicine (Family Medicine) Physician (207QS0010X) |
United | 99493 | $134.66 | 1568751006 - ELIZABETH RIVERA | 352526373 - ACCLAIM PHYSICIAN GROUP INC | TX | Family Medicine Physician (207Q00000X) |
United | 99493 | $108.94 | 1215321492 - ANIL RATHI | 273396768 - (TX) ELITE PATIENT CARE, PLLC | TX | Internal Medicine Physician (207R00000X) |
United | 99493 | $147.41 | 1821080995 - LUAN PHO | 752773665 - (TX) LUAN Q PHO MD PA | TX | Internal Medicine Physician (207R00000X) |
United | 99493 | $259.82 | 1982669883 - MARC TRIBBLE | 842004011 | TX | Internal Medicine Physician (207R00000X) |
United | 99493 | $67.45 | 1174844633 - ROLANDO PEREZ | 742429518 - (TX) COASTAL BEND WELLNESS FOUNDATION INC | TX | Family Medicine Physician (207Q00000X) |
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 99493 vs. Other Psychiatric Collaborative Care Management Services Codes
The CPT 99493 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 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.
| Code | Complexity | Description |
|---|---|---|
| 99203-CPT | Low | Office Or Other Outpatient Visit For The Evaluation And Management Of A New Patient Which Requires A Medically Appropriate History And/Or Examinationand 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. (Desc Rvsd 1/1/2024) |
| 99484-CPT | 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-CPT | 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. |
| 99493-CPT | Low | 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 Physicianor 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 |
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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